Medical Management Specialist I

Job Title: Medical Management Specialist I
Location: Skokie, IL 60077
Duration: 6 Months+ (Possible Extension)

Pay Range: $40 - $42/hr. on W2
 
Type: Full-time, field-based
Location: Chicago or Western/Northern suburbs
Travel: Required within assigned territory
Purpose: Conduct medical management and health education programs for government health care program members, gather and analyze regulatory data, and represent the company to members
 
Key Responsibilities:

• Conduct medical management and health education programs for members of government health care programs
• Gather, analyze, and provide data for regulatory reporting
• Serve as the company representative to members, addressing clinical questions and concerns
• Collaborate with internal staff, management, and external vendors/community resources
• Provide education and guidance on clinical and wellness issues

 
Required Qualifications:

• RN with ≥3 years of direct clinical care experience or LPC/LMSW with ≥2 years of clinical practice to obtain license
• Current, valid, unrestricted license in the state of operations (or obtain within 90 days if compact licensee)
• ≥3 years wellness or managed care experience presenting clinical issues with members/physicians
• Knowledge of the health and wellness marketplace and employer trends
• Strong verbal and written communication skills
• Analytical experience, including medical data analysis
• Current driver’s license, reliable transportation, and insurance
• PC proficiency: Microsoft Word, Excel, PowerPoint, databases, and web-based applications

 
Preferred Qualifications:

• ≥3 years clinical experience
• Patient education experience
• Condition Management experience
• Bilingual (English/Spanish)
• Transition of Care experience
• Experience managing complex or catastrophic cases
• Certification in Case Management, Training, Project Management, or nationally recognized healthcare certification