Medical Management Specialist I

Job Title: Medical Management Specialist I
Location: Downers Grove, IL
Duration: 6 Months (possibility extension)
Shift/Schedule: Mon – Fri – 8AM – 5PM
Pay rate: $40-41/hr. on w2
 
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 date for regulatory reports.
• This position will represent the company to members.

 
JOB PURPOSE:

• This position is 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. 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.
• Transition of Care experience.
• Experience in managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management or nationally recognized health care certification.

Salary : $40 - $41