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Job Requirements of Medical Management Specialist I:
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Employment Type:
Contractor
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Location:
Raton, NM (Onsite)
Do you meet the requirements for this job?
Medical Management Specialist I
Careers Integrated Resources Inc
Raton, NM (Onsite)
Contractor
Job Title: Medical Management Specialist I
Job Location: NM (Remote + Field Visit) - Colfax County, Union County, Harding County, NM
Job Duration: 6 Months+ (Possible Extension)
Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri)
Job Summary:
Job qualifications:
Preferred Job Qualifications:
Job Location: NM (Remote + Field Visit) - Colfax County, Union County, Harding County, NM
Job Duration: 6 Months+ (Possible Extension)
Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri)
Job Summary:
- This position will be assigned 60-80 members at a time, travel distance is dependent on where the contingent workers lives, however, we try to keep them around 180 miles max.
- Preferred work location to be in Raton, NM or in the counties being covered, Colfax County, Union County, Harding County.
- Responsible for conducting medical management and health education programs for customers on government health care programs.
- Other responsibilities include gathering, analysing, and providing data 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 driver's license, transportation, and applicable insurance.
- 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.
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