Job Description

Title: Medical Management Specialist I (RN)

Location: REMOTE in IL (with some field visit in Danville, IL )

Duration: 6+ months (contract to hire)

Job 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 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).
• 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 includes 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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