Medical Management Specialist I
Gurnee and Waukegan, Illinois
Employer: w3r Consulting
Industry: Registered Nurse/LPN, Case Manager
Salary: Competitive
Job type: Full-Time
Description: This position is responsible for conducting medical management and health education programs for customers on government health care programs. This role will include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.
JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.
JOB QUALIFICATIONS:
*Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
* Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
* Plus 3 years wellness or managed care experience presenting clinical issues with members/physicians.
* Knowledge of the health and wellness marketplace and employer trends.
* Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
* Analytical experience including medical data analysis.
* Current IL driver's license, transportation and applicable insurance. (for IL)
* Ability and willingness to travel within assigned territory.
* PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
PREFERRED JOB QUALIFICATIONS:
* 3 years clinical experience.
* Patient education experience.
* Condition Management experience.
* Bilingual in English and Spanish.
* Transition of Care experience.
* Experience in managing complex or catastrophic cases.
* Certification in Case Management, Training, Project Management or nationally recognized health care certification.
JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.
JOB QUALIFICATIONS:
*Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
* Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
* Plus 3 years wellness or managed care experience presenting clinical issues with members/physicians.
* Knowledge of the health and wellness marketplace and employer trends.
* Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
* Analytical experience including medical data analysis.
* Current IL driver's license, transportation and applicable insurance. (for IL)
* Ability and willingness to travel within assigned territory.
* PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
PREFERRED JOB QUALIFICATIONS:
* 3 years clinical experience.
* Patient education experience.
* Condition Management experience.
* Bilingual in English and Spanish.
* Transition of Care experience.
* Experience in managing complex or catastrophic cases.
* Certification in Case Management, Training, Project Management or nationally recognized health care certification.
Created: 2024-05-15
Reference: 46478
Country: United States
State: Illinois
City: Gurnee and Waukegan
Similar jobs:
-
Traffic Management Specialist
U.S. Army Military Surface Deployment and Distribution Command in Scott AFB, Illinois -
Admission Registration Specialist 1
RUSH Oak Park Hospital in Chicago, Illinois -
Financial Specialist - Revenue Cycle
Rush Hospital in Chicago, Illinois -
Senior Hearing Aid Specialist
Costco in SCHAUMBURG, Illinois -
CLINICAL DISCHARGE SUMMARY SPECIALIST
UHS in Streamwood, Illinois -
To Go Specialist
Olive Garden in Springfield, Illinois -
Store Protection Specialist
Ross Stores in Fairview Heights, Illinois -
EHS Engineering Specialist
Saint Gobain in Bedford Park, Illinois -
Financial Specialist - Revenue Cycle
RUSH Oak Park Hospital in Chicago, Illinois -
Loss Prevention Specialist
Restaurant Depot in Gurnee, Illinois💸 $17.50 - $18.09 per hour -
92W Water Treatment Specialist
Army National Guard in Mattoon, Illinois -
Family Services Specialist
ambercare in Cllinton, Illinois💸 $14 per hour -
Wax Specialist
European Wax Center in Buffalo Grove, Illinois -
25U Signal Support Systems Specialist
Army National Guard in East St. Louis, Illinois -
Member Specialist
Sam's Club in CHAMPAIGN, Illinois💸 $17.00 - $24.00 per hour -
Project Delivery Specialist - Lead Data Engineer
Deloitte in Chicago, Illinois -
Senior Sustainability Specialist - Environmental Services (Multiple Locations)
Burns & McDonnell in Downers Grove, Illinois -
Vendor Operations Specialist
Medline Industries in Northfield, Illinois -
Wax Specialist
European Wax Center in Crystal Lake, Illinois -
Top Secret Cleared Voice Specialist (Shifts)
Insight Global in O Fallon, Illinois