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Medical Management Specialist

BCVS Group
Santa Fe, NM Full Time
POSTED ON 1/4/2025
AVAILABLE BEFORE 2/23/2025

Position:- RN Clinical Care Coordinator / Medical Management Specialtities

Rate:- $41.50/hr.
Location:- Santa Fe, NM (Fully Remote but candidate should reside in NM)

Job Description:-

Description

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 date for regulatory reports. This position will represent the company to members.

JOB QUALIFICATIONS:

  • Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
  • 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 Experience in Managed care 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.
  • Current driver's license, transportation and applicable insurance.
  • Ability and willingness to travel within assigned territory.
  • PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.

PREFERRED JOB QUALIFICATIONS:

  • 3 years clinical experience.
  • Patient education experience.

Job Type: Contract

Pay: From $41.50 per hour

Expected hours: 40 per week

Benefits:

  • 401(k)
  • Dental insurance
  • Life insurance
  • Vision insurance

Schedule:

  • 8 hour shift
  • Morning shift

Experience:

  • Clinical care: 2 years (Required)
  • Registered Nurse: 3 years (Required)

License/Certification:

  • NM State license (Required)

Work Location: Remote

Salary : $42

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