Behavioral Health Care Management Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Facilitate care management and health education initiatives for clients involved in government health care programs

• Collect, evaluate, and present data for compliance reports

• Act as a representative of the organization to members

• Engage in discussions regarding medical requirements with members

• Collaborate with internal personnel, management, external vendors, and community resources

• Independently manage medical management and health education initiatives

• Travel within the designated territory as necessary

⛳️ Requirements

• Registered Nurse (RN) with a minimum of 2 years of direct clinical care experience in a healthcare setting, or hold an unrestricted LPC, LMSW, LCPC, LCSW, LMFT, LPCC, LISW, or LMHC license as mandated by state regulations

• Possess a current, valid, and unrestricted license in the state of operation (or through reciprocity)

• RN with a compact license relocating permanently must secure active, unrestricted RN licensure in the state of operation within 90 days of employment

• 3 years of experience in wellness or managed care, addressing clinical concerns with members and physicians

• Proven ability to independently manage medical management and health education initiatives

• Familiarity with the health and wellness marketplace and current employer trends

• Strong verbal and written communication skills for discussing medical needs and collaborating with staff, management, vendors, and community resources

• Experience in medical data analysis

• Proficient in PC applications including Word, Excel, PowerPoint, databases, and web-based platforms

• Willingness and ability to travel within the assigned territory

• Preferred: 3 years of clinical experience

• Preferred: Background in Behavioral Health

• Preferred: Experience in patient education

• Preferred: Experience in Condition Management

• Preferred: Bilingual in English and Spanish

• Preferred: Experience managing complex or catastrophic cases

• Preferred: Certification in Case Management, Training, Project Management, or a nationally recognized health care certification

• Preferred: Background in Government Programs

• Preferred: Experience in Population Management

🏝️ Benefits

• Customized development plans that promote growth and professional advancement

• Employee referral program

• Unionized position

• Equal opportunity workplace

• Drug-free and smoke-free environment