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Medical Management Specialist I

Integrated Resources, Inc

Downers Grove, IL

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JOB DETAILS
SALARY
$40–$41 Per Hour
SKILLS
Analysis Skills, Certified Case Manager (CCM), Clinical Competency, Clinical Medicine, Communication Skills, Computer Skills, Customer Support/Service, Data Analysis, Database Technology, Driver's License, Government, Health Education, Healthcare, Internet Application, Managed Care, Market Trend Analysis, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Patient Education, People Management, Presentation/Verbal Skills, Project/Program Management, Registered Nurse (RN), Regulatory Reports, Social Work, Willing to Travel, Writing Skills
LOCATION
Downers Grove, IL
POSTED
30+ days ago
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.

About the Company

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Integrated Resources, Inc