Government Programs Care Manager III

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

📋 Description

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

• Educate and inform members about healthcare programs that cater to their personal health requirements.

• Initiate conversations with members regarding their adherence to personal health objectives.

• Address inquiries from members promptly.

• Assist clinical operations by engaging in activities with providers and members.

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

• Perform comprehensive health assessments and develop care plans.

• Visit members' residences and/or facilities as necessary to support complex and specialty populations.

• Discuss clinical matters with both members and physicians.

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

• Travel within the designated territory.

⛳️ Requirements

• Registered Nurse (RN) with 2 years of direct clinical care experience, or an unrestricted behavioral health/social work license with 2 years of clinical practice experience.

• Must possess a current, valid, unrestricted license in the state of operations (or have reciprocity).

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

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

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

• Strong verbal and written communication abilities.

• Analytical experience, including the ability to analyze medical data.

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

• Experience with databases and web-based applications.

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

• Willingness and ability to travel within the assigned territory.

• Must meet state-specific qualifications for Illinois and Texas programs as outlined.

• Preferred: 3 years of direct clinical experience.

• Preferred: Experience in patient education.

• Preferred: Knowledge in Condition Management.

• Preferred: Bilingual skills in English and Spanish.

• Preferred: Experience 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: Knowledge in Population Management.

🏝️ Benefits

• Professional development plans.

• Health and wellness benefits.

• 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.