Government Programs Care Manager l

Government Programs Care Manager l

Requirements

• Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience
• Knowledge of medical terminology
• Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs
• PC proficiency including Microsoft Office applications
• Customer service skills
• Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues

Responsibilities

• Contacting identified members to inform and educate them on health care programs to address their personal health plan needs
• Engaging the member in discussion of adherence to personal health plans
• Responding to inquiries from members
• Supporting the clinicians in the Medical Management department with their provider and member activities

Preferred Qualifications

• Case Management experience – HIGHLY PREFERRED
• Professional verbal and written communication skills and professional phone experience – HIGHLY PREFERRED
• LPN – HIGHLY PREFERRED
• Nurses must be licensed in their state(s)
• Payor insurance experience
• Spanish bilingual a plus