Logo of Huzzle

Home

Matches

Explore

Manage

Medical Management Specialist

image

Health Care Service Corporation

Jun 21

  • Job
    Full-time
    Mid & Senior Level
  • Healthcare
  • Albuquerque
  • Quick Apply

AI generated summary

  • You must be a licensed healthcare professional with 2 years clinical experience, analytical skills, communication abilities, and willingness to travel. Bilingual and certification a plus.
  • You will conduct medical management and health education programs, gather data for reports, provide assessments and care planning, and represent the company to members, providers, and state regulators.

Requirements

  • Registered Nurse (RN), Licensed Professional Counselor (LPC), Licensed Clinical Professional Counselor (LCPC), Licensed Master Social Worker (LMSW), 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.
  • 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.
  • Preferred Job Qualifications:
  • Plus 1 year wellness or managed care experience.
  • 3 years clinical experience.
  • Patient education experience.
  • Condition Management experience.
  • Bilingual in English and Spanish.
  • Experience in managing complex or catastrophic cases.
  • Certification in Case Management, Training, Project Management or nationally recognized health care certification.

Responsibilities

  • 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 data for regulatory reports.
  • Perform assessments, care planning and care coordination in the member/family home and telephonically.
  • This position will represent the company to members, providers and state regulators.

FAQs

What are the main responsibilities of a Medical Management Specialist at HCSC?

The main responsibilities of a Medical Management Specialist at HCSC include overseeing medical management programs, collaborating with healthcare providers, analyzing medical data, and ensuring quality care for members.

What kind of development opportunities are available for Medical Management Specialists at HCSC?

At HCSC, we provide curated development plans for our employees to set their learning path and advance their careers. Medical Management Specialists have access to a variety of training and development opportunities to enhance their skills and knowledge.

How does HCSC support the career growth of Medical Management Specialists?

HCSC is committed to investing in the future of our employees, including Medical Management Specialists. We provide career advancement opportunities, mentorship programs, and ongoing support to help employees advance in their careers within the company.

What qualities are you looking for in candidates applying for the Medical Management Specialist position at HCSC?

We are looking for candidates who are passionate about healthcare, have strong analytical skills, excellent communication abilities, and the ability to work collaboratively with healthcare providers. Candidates should also demonstrate a commitment to delivering high-quality care to our members.

Health Care Service Corporation

Empowering Whole Person Health With Compassion and Innovation

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible.