Job Description

Job Description

Job Purpose

This Contract to Hire position is responsible for conducting medical management and health education programs for members enrolled in government health care programs . This role can work remotely but will be visiting 50-70 members on a quarterly basis in their home or in their facilities. The role involves gathering, analyzing, and providing data for regulatory reporting while serving as a representative of the company to members.

Key Responsibilities

• Conduct medical management and health education programs for customers.
• Gather, analyze, and prepare data for regulatory reports .
• Communicate and collaborate with members, physicians, internal teams, and community resources.
• Provide clinical guidance and support to improve member health outcomes.
• Travel within assigned territory as needed.

Required Qualifications

• Registered Nurse ( RN ) with at least 3 years of direct clinical care , or Licensed Professional Counselor ( LPC ), or Licensed Master Social Worker ( LMSW ) with 2 years of clinical practice to obtain licensure.
• Must hold a current, valid, and unrestricted license in the state of operation (or reciprocity).
• Compact license holders must obtain active RN licensure in the state of operation within 90 days of hire.

Experience:

• 3+ years in wellness or managed care , presenting clinical issues to members and physicians.
• Strong understanding of the health and wellness marketplace and employer trends .
• Experience with medical data analysis .
• Skills:
• Excellent verbal and written communication skills.
• PC proficiency : Word, Excel, PowerPoint, databases, and web-based applications.
• Must have current driver’s license, transportation, and insurance .

Preferred Qualifications

• 3+ years of clinical experience.
• Experience in patient education , condition management , or transition of care .
• Case Management or Project Management certification (or another recognized health care certification).
• Experience managing complex or catastrophic cases .
• Bilingual in English and Spanish.

Solving IT, a Woman and LGBTQ+ owned and operated organization is thrilled to provide a comprehensive benefit package to all our W2 employees and their families. We are proud to offer five diverse health plan options as well as a PPO dental plan through Blue Cross Blue Shield, Term Life/AD&D Insurance, and a 401(k) Savings Plan. Solving IT covers a portion of the health and dental premiums for our employees.

As you progress in your professional journey, Solving IT is dedicated to accommodating your evolving preferences and matching you with fulfilling projects. We champion equality and embrace diversity in all its forms. Creating an atmosphere that encourages varied perspectives to collaborate fosters personal development, strengthens team unity, and contributes to the overall success of the organization!

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