Medical Management Specialist I

Medical Management Specialist I

Location: (Remote+ Home Visit)- Rockford, IL (Winnebago, Boone, Ogle & Stephenson Counties, IL) Duration: 6+ months (possible extension) + Contract to Hire Schedule: 40hr, Mon - Fri, 8:00am - 4:30pm Pay Rate: $42.00/ hr. to $43.93/ hr. on w2. ( Along with Mileage reimbursement separately).

Job Description:

• 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 data 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 include 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.