Medical Management Specialist
Location: MARION, IL
Duration: 6 Months Contract to Hire
· 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.
· Registered Nurse (RN)
· 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)
· Current NM driver’s license transportation and applicable insurance (for NM)
· 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.