Government Programs Care Manager III

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

📋 Description

• Facilitate care coordination for members through telephonic and/or field-based management.

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

• Involve members in conversations about achieving their personal health objectives.

• Address member inquiries effectively.

• Assist clinical operations with activities involving providers and members.

• Conduct health screenings for members via telephone and/or in the field.

• Perform thorough health assessments and develop care plans.

• Visit members at their homes and/or facilities as required to assist complex and specialty populations.

• Discuss clinical concerns with members and healthcare professionals.

• Travel within the designated territory as needed.

⛳️ Requirements

• Registered Nurse (RN) with two years of direct clinical care experience in a healthcare setting, or an unrestricted Licensed Professional Counselor (LPC, TX), Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL), Licensed Clinical Social Worker (LCSW, IL & NM), Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor (LMHC, NM) with two years of clinical practice experience.

• A current, valid, unrestricted license in the state of operation (or reciprocity).

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

• Three years of wellness or managed care experience involving clinical discussions with members and physicians.

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

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

• Analytical skills, including experience with medical data analysis.

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

• A current unrestricted driver’s license, reliable transportation, and appropriate insurance.

• Willingness and ability to travel within the assigned territory.

• Texas only: Experience with Level 3 children exhibiting behavioral health issues, specifically working with children and young adults facing similar conditions or behaviors within three of the last five years.

🏝️ Benefits

• Tailored 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.

• Annual incentive bonus program.

• Additional incentives.

• Comprehensive total rewards package.