Medical Management Specialist
Reference Code: 6632
Position: Medical Management Specialist
Duration: 6 months Contract to Hire
Location Address: Downers Grove, IL
PR: $35/hr W2 with benefits
Our client, a trusted health insurance plan provider, is looking to hire a Medical Management Specialist who will be 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.
- 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.
For more information on the Medical Management Specialist role, please call our Recruiter directly at (847)306-9935. To submit your application, click on the 'Apply for Job' link below or send your resume directly to Christopher.firstname.lastname@example.org.
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