Job Title: Medical Management Specialist
Location: Preferred work location to be in Raton, NM or in the counties being covered, Colfax County, Union County, Harding County. | Hybrid
Duration: 6+ months contract to hire
Pay rate: $40.00/hr on W2 or $80k conversion salary
JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.
JOB QUALIFICATIONS:
*Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
* Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
* Plus 3 years wellness or managed care experience presenting clinical issues with members/physicians.
* Knowledge of the health and wellness marketplace and employer trends.
* Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
* Analytical experience including medical data analysis.
* Current driver's license, transportation and applicable insurance.
* Ability and willingness to travel within assigned territory.
* PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
PREFERRED JOB QUALIFICATIONS:
* 3 years clinical experience.
* Patient education experience.
* Condition Management experience.
* Bilingual in English and Spanish.
* Transition of Care experience.
* Experience in managing complex or catastrophic cases.
* Certification in Case Management, Training, Project Management or nationally recognized health care certification.
Creating A Healthier Way of Living Rinnai America Corporation is the leader in tankless water heating, a technology that is growing rapidly as businesses and homes yank the tank and convert to an efficient, endless supply of hot water and the only tankless water heating...
...Science Tutors Wanted! Beautiful Office, Great Training! $35-$40/hr. Join the most professional 1-on-1 tutoring team in the Bay Area. If you're bright, energetic, and eager to meet students in person, wed love to talk with you! Ideal Science Tutors are: College graduates...
...**This role will require travel between two facilities in the Evansville, IN area. The proposed schedule includes weekdays and one weekend day.*** Launch or Grow Your Career in Post-Acute Care! Are you a Physician Assistant (PA-C) looking for a rewarding and...
...Behavior Analyst (BCBA) Location: Bridgeton, MO Job Type: Full-Time About Us Latitude Therapy is a St. Louis-based, therapist and woman owned and operated ABA therapy company. We are a mission-driven provider of high-quality ABA services for children and families...
Looking for someone either Live-In or Couple hours Morning and Night. In Summary: Looking for someone who can help assist with Incontinence, Obesity, Memory Issues, Mobility Issues, and overall Cleaniness/Organization. Morning: Bathe, Change, Chair Transfer. Meal Prep. ...