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Medical Management Specialist I - Care Coordination

Company: HCSC
Location: Downers Grove
Posted on: May 17, 2023

Job Description:

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

Job Summary

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.


**This is a Work from Home position - field position with traveling to members homes**

**We are needing candidates in Cook County, IL and Lake County, IL (Hyde Park, Lincoln Park, University of IL Chicago area, Skokie, DesPlaines, Glenview, Shaumburg, Carol Stream, Waukengan, Gurnee, etc locations)**

Required Job Qualifications:

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.

Plus 3 years' 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 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:

3 years clinical experience.

Field experience.

Prior MCO experience.

Home Health experience.

Patient education experience.

Condition Management experience.

Bilingual in English and Spanish.

Experience in managing complex or catastrophic cases.

Certification in Case Management.





We encourage people of all backgrounds and experiences to apply.

Even if you don't meet every listed qualification, apply anyway - you might have qualifications we haven't even thought of yet.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Keywords: HCSC, Downers Grove , Medical Management Specialist I - Care Coordination, Healthcare , Downers Grove, Illinois

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