Compensation: Up to $80,000 per year

Job Purpose: This position is responsible for conducting medical management and health education programs for customers on government health care programs. The role includes gathering, analyzing, and providing data for regulatory reports and representing the company to members.

Key Responsibilities:

• Provide care during the pregnant and postpartum period for case management.
• Conduct medical management and health education programs for customers.
• Gather, analyze, and provide data for regulatory reports.
• Represent the company to members.

Job Qualifications:

• Required:
• Registered Nurse (RN) with 3 years of direct clinical care in a clinical setting, or
• Licensed Professional Counselor (LPC), or
• Licensed Master Social Worker (LMSW) with 2 years of clinical practice.
• Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensees changing permanent residence to the state of operations, active, unrestricted RN licensure must be obtained within 90 days of hire.
• 3 years of 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, including Word, Excel, PowerPoint, database experience, and web-based applications.
• Current driver's license, transportation, and applicable insurance.
• Ability and willingness to travel within the assigned territory.

• Preferred:
• 3 years of 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.