Medical Management Nurse Job at Tap Growth ai, Albuquerque, NM

eXZ3V3ZvVFZ3a1NhVlRxZEt1NkZjUFVXUnc9PQ==
  • Tap Growth ai
  • Albuquerque, NM

Job Description

We're Hiring: Medical Management Specialist!

We are seeking an experienced Medical Management Specialist to oversee healthcare operations, ensure compliance with medical regulations, and optimize patient care delivery.

Location: Central Albuquerque, NM

Work Mode: On-site

Role: Medical Management Specialist

Job Description

This position is responsible for conducting medical management and health education programs for customers on government health care programs. This role will include gathering, analyzing, and providing data for regulatory reports. This position will represent the company to members.

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 licensees 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.
  • 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.

Good to have:

  • 3 years 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.

Job Tags

Permanent employment,

Similar Jobs

Southern New Hampshire Health

Licensed Nursing Assistant LNA - Telemetry - Days Job at Southern New Hampshire Health

 ...ll Love Us ~ Health, dental, prescription, and vision coverage for full-time & part-time employees ~ Competitive pay ~ Tuition Reimbursement ~403(b) Retirement Savings Plan ~ Education & Paid training courses for continued career progression & So much more!

Logistify

Remote Transportation Manager - Logistic & Freight Coordination Job at Logistify

 ...About Us: We are a fast-growing logistics solutions company that partners with manufacturers, distributors, and shippers nationwide....  .... The Opportunity: Were looking for a Transportation Manager (or experienced logistics professional) who understands the challenges... 

Quest Diagnostics

Dermatopathologist with General Surgical Sign-Out Job at Quest Diagnostics

 ...Description Dermatopathologist with General Surgical Sign-Out Schaumburg IL Our laboratory located in Schaumburg IL (a suburb of...  ...who request to speak with a pathologist Provide expertise and help to technologists and technicians to resolve problems Participate... 

Wells Fargo

Senior Commercial Loan Servicing Specialist-Agency Services Job at Wells Fargo

 ...About this role: Wells Fargo is seeking a Senior Commercial Loan Servicing Specialist as part of the Agency Services team within Corporate and Investment Banking Loan Operations (CIBLO). This team supports syndicated loans and their transactions. The Specialist will... 

KEMCO Facilities Services

Janitorial Cleaner Job at KEMCO Facilities Services

Job description Job Description Kemco Integrated Facilities is a full-service facilities provider located in Montgomery, AL. We live and work our core values of integrity, honesty, trust, accountability, commitment to customers, passion, and fun. Position Summary...