Government Programs Care Manager III

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

📋 Description

• Deliver care coordination to members through telephonic and/or in-person care management.

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

• Engage members in conversations regarding adherence to their personal health objectives.

• Address member inquiries promptly.

• Assist clinical operations through interactions with both providers and members.

• Conduct telephonic and/or field-based health screenings for members.

• Perform thorough health assessments and develop care plans.

• Visit members’ residences and/or facilities as necessary for complex and specialty populations.

• Travel 2–3 days weekly within Dona Ana, New Mexico, and neighboring areas up to Raton, New Mexico.

• Work Monday to Friday from 8 AM to 5 PM MST.

⛳️ Requirements

• Registered Nurse (RN) with 2 years of direct clinical care experience in a clinical environment, or an unrestricted behavioral health license with 2 years of clinical practice.

• Must hold a current, valid, unrestricted license in the state of New Mexico (or reciprocity).

• Compact RN licensees relocating must secure active, unrestricted RN licensure in the state of operations within 90 days of employment.

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

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

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

• Experience in analytical tasks including medical data analysis.

• Proficiency in PC applications such as Word, Excel, and PowerPoint.

• Experience with databases and web-based applications.

• Must possess a current unrestricted driver’s license, transportation, and applicable insurance.

• Capability and readiness to travel within the assigned territory.

• Preferred: 3 years of direct clinical experience.

• Preferred: Experience in patient education.

• Preferred: Experience 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 health care certification.

• Preferred: Experience with Government Programs.

• Preferred: Involvement in Population Management.

• Sponsorship is not available.

🏝️ Benefits

• Customized development plans and opportunities for professional growth.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance.

• Supplemental life insurance.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement.

• Additional incentives.

• Annual incentive bonus plan.