Remote Medical Management Specialist I 29970 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. This position is remote near Farmington, NM.

Responsibilities:

• Conducting medical management and healtheducation programs for customers on government health careprograms.
• Gathering, analyzing and providing date for regulatoryreports.
• 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.

Preferred Job Requirements:

• 3 years clinicalexperience.
• Patient education experience.
• Condition Managementexperience.
• Bilingual in English and Spanish.
• Transition ofCare experience.
• Experience in managing complex or catastrophiccases.
• Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.

Benefits :

Solving IT, a Woman and LGBTQ owned and operatedorganization is thrilled to provide a comprehensive benefit packageto all our W2 employees and their families, regardless of gender.

We are proud to offer five diverse health plan options as well as aPPO dental plan through Blue Cross Blue Shield, Term Life/AD&DInsurance, and a 401(k) Savings Plan. Solving IT covers a portionof the health and dental premiums for our employees. As youprogress in your professional journey, Solving IT is dedicated toaccommodating your evolving preferences and matching you withfulfilling projects. We champion equality and embrace diversity inall its forms. Creating an atmosphere that encourages variedperspectives to collaborate fosters personal development,strengthens team unity, and contributes to the overall success ofthe organization! Whether you’re seeking your next career challengeor aiming to stay abreast of industry trends, Solving IT iscommitted to supporting your career advancement. We activelyencourage applications from all backgrounds and utilize the mostup-to-date market insights and compensation data to ensure that youreceive not just advice, but the complete Solving ITExperience.