Government Programs Care Manager III

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

📋 Description

• Deliver care coordination to members through telephonic and/or field-based management.

• Educate and inform members about healthcare programs tailored to their individual health needs.

• Facilitate discussions with members regarding their adherence to personal health objectives.

• Address inquiries from members effectively.

• Assist clinical operations with activities involving both providers and members.

• Conduct health screenings via telephonic and/or field-based methods.

• Perform comprehensive health assessments and develop care plans.

• Visit members in their homes and/or facilities as necessary to support complex and specialty populations.

• Present clinical matters to both members and physicians.

• Collaborate with internal staff, management, external vendors, and community resources.

• Travel within the designated territory.

⛳️ Requirements

• Registered Nurse (RN) with a minimum of 2 years of direct clinical care experience in a clinical setting, or an applicable unrestricted behavioral-health license (LPC, LMSW, LCPC, LCSW, LMFT, LPCC, LISW, or LMHC) with 2 years of clinical practice experience.

• Current, valid, and unrestricted license within the state of operations (or reciprocity).

• Compact RN licensees changing their permanent residence must secure active, unrestricted RN licensure in the state of operations within 90 days of hire.

• 3 years of experience in wellness or managed care, addressing clinical issues with members/physicians.

• Familiarity with the health and wellness market and employer trends.

• Strong verbal and written communication skills for discussing medical needs and interacting with internal staff, management, external vendors, and community resources.

• Experience in analytical tasks, including medical data analysis.

• Proficiency in PC applications including Word, Excel, PowerPoint, databases, and web-based tools.

• Valid unrestricted driver’s license, reliable transportation, and appropriate insurance coverage.

• Willingness and ability to travel within the assigned territory.

• Specific Illinois waiver qualifications as stated, including relevant RN, social work, counseling, nursing, case management, human services, or related credentials and experience.

• Texas-specific experience working with children and young adults exhibiting similar behavioral health conditions or behaviors within three of the last five years.

• Preferred: 3 years of direct clinical experience.

• Preferred: Experience in patient education.

• Preferred: Background in condition management.

• Preferred: Bilingual proficiency in English and Spanish.

• Preferred: Experience in managing complex or catastrophic cases.

• Preferred: Certification in Case Management, Training, Project Management, or a nationally recognized healthcare certification.

• Preferred: Experience with Government Programs.

• Preferred: Background in Population Management.

• Preferred: Experience in MCO case management.

• Must live within a 60-mile radius of the Chicago office.

• Remote work is permitted within the continental United States, excluding California, New York, Alaska, and Hawaii.

🏝️ Benefits

• Customized development plans that foster professional development and career advancement.

• Union position.

• Flexible remote/telecommute work arrangement.