Medical Management Specialist I - LTC "Community Transition Team"

Aurora, Chicago, Naperville, Illinois
Jun 28, 2022
Jul 28, 2022
Contract Type

 *** Opportunity to receive a  $5,000 sign on bonus ***

 **This is a Work from Home position with traveling to Members's homes**

**This is a telecommuter field based position - located in Cook/Collar Counties**

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs - Long Term Care Community Transition Team. Accountabilities include gathering, analyzing and providing date for regulatory reports. Perform assessments and other care review in the member/family home/nursing home.  This position will represent the company to members.

* Registered Nurse (RN), Licensed Professional Counselor (LPC), Licensed Clinical Professional Counselor (LCPC), Licensed Social Worker (LSW), Licensed Clinical Social Worker (LCSW) OR Licensed Mental Health Counselor (LMHC) with 2 years direct clinical care to the consumer in a clinical setting.
* 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.
* PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
* Current unrestricted driver’s license, transportation and applicable insurance.
* Ability and willingness to travel within assigned territory

* 3 years clinical experience.
* Long Term Care experience.
* Field experience.
* Discharge Planning experience.
* Patient education experience.
* Colbert Consent Decree knowledge.
* Bilingual in English and Spanish.
* Certification in Case Management, Training, Project Management or nationally recognized health care certification.


HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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