Medical Management Specialist I 29963 Position Available In Fulton, Georgia

Job Description:

One of the largest health insurers in the nation is focused oncontinuously building an industry-defining, world-class ITcapability. Healthcare is forever evolving, especially due toemerging technologies, making this a great experience to add toyour resume. Come join their winning team! This contract to hirerole as a Remote Medical Management Specialist I is responsible forconducting medical management and health education programs forcustomers on government health care programs. This role willinclude gathering, analyzing and providing date for regulatoryreports. Perform assessments, care planning and care coordinationin the member/family home and telephonically. This position willrepresent the company to members.

Responsibilities:

• Conductingmedical management and health education programs for customers ongovernment health care programs.
• Accountabilities includegathering, analyzing and providing date for regulatory reports.
• This position will represent the company to members.

JobRequirements:

• Registered Nurse (RN), with 3 years direct clinicalcare to the consumer in a clinical setting or Licensed ProfessionalCounselor (LPC), or Licensed Master Social Worker (LMSW), whichincludes 2 years of clinical practice to obtain their LPC or LMSWlicense.
• Current, valid, unrestricted license in the state ofoperations (or reciprocity). For compact licensee changingpermanent residence to state of operations, you must obtain active,unrestricted RN licensure in the state of operations within 90 daysof hire.
• Plus 3 years wellness or managed care experiencepresenting clinical issues with members/physicians.
• Knowledge ofthe health and wellness marketplace and employer trends.
• Verbaland written communication skills including discussing medical needswith members and interfacing with internal staff/management andexternal vendors and community resources.
• Analytical experienceincluding medical data analysis.
• Current driver’s license,transportation and applicable insurance.
• Ability and willingnessto travel within assigned territory.
• PC proficiency to includeWord, Excel, and PowerPoint, database experience and Web basedapplications.
• Must reside near Santa Fe County, NM.

Preferred JobRequirements:

• 3 years clinical experience.
• Patient educationexperience.
• Condition Management experience.
• Bilingual inEnglish and Spanish.
• Transition of Care experience.
• Experiencein managing complex or catastrophic cases.
• Certification in CaseManagement, Training, Project Management or nationally recognizedhealth care certification.

Benefits :

Solving IT, a Woman and LGBTQowned and operated organization is thrilled to provide acomprehensive benefit package to all our W2 employees and theirfamilies, regardless of gender. We are proud to offer five diversehealth plan options as well as a PPO dental plan through Blue CrossBlue Shield, Term Life/AD&D Insurance, and a 401(k) SavingsPlan. Solving IT covers a portion of the health and dental premiumsfor our employees. As you progress in your professional journey,Solving IT is dedicated to accommodating your evolving preferencesand matching you with fulfilling projects. We champion equality andembrace diversity in all its forms. Creating an atmosphere thatencourages varied perspectives to collaborate fosters personaldevelopment, strengthens team unity, and contributes to the overallsuccess of the organization! Whether you’re seeking your nextcareer challenge or aiming to stay abreast of industry trends,Solving IT is committed to supporting your career advancement. Weactively encourage applications from all backgrounds and utilizethe most up-to-date market insights and compensation data to ensurethat you receive not just advice, but the complete Solving ITExperience.