Government Programs Care Manager III (Peoria , IL)
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job SummaryThis position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations
Required Job Qualifications:
Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
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 direct clinical experience.
Patient education experience.
Condition Management experience.
Bilingual in English and Spanish.
Experience in managing complex or catastrophic cases.
Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.
Government Programs experience
Population Management
This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting **************************************
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$26.37 - $58.19
Exact compensation may vary based on skills, experience, and location.
$26.4-58.2 hourly Auto-Apply 60d+ ago
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Government Programs Care Manager III (Peoria , IL)
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job SummaryThis position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations
Required Job Qualifications:
Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
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 direct clinical experience.
Patient education experience.
Condition Management experience.
Bilingual in English and Spanish.
Experience in managing complex or catastrophic cases.
Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.
Government Programs experience
Population Management
This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting **************************************
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$26.37 - $58.19
Exact compensation may vary based on skills, experience, and location.
$26.4-58.2 hourly Auto-Apply 60d+ ago
Remote Finance Special Projects Lead
Humana Inc. 4.8
Washington, DC jobs
A leading health services organization is seeking a Lead - Finance Special Projects to drive process improvements within the Finance function. This position requires collaboration with Finance leadership to optimize operations and promote technology adoption. Candidates should have a Bachelor's degree in Finance or related field and extensive experience in benchmarking and projectmanagement. This role involves creating project plans and tracking progress to ensure successful project delivery. Various benefits and a compensation range of $94,900 - $130,500 annual are offered.
#J-18808-Ljbffr
$94.9k-130.5k yearly 1d ago
Remote Finance Special Projects Lead
Humana Inc. 4.8
Urban Honolulu, HI jobs
A healthcare organization is seeking a Lead - Finance Special Projects in Honolulu, Hawaii to drive process improvements within Finance. The ideal candidate will have a Bachelor's degree, extensive experience in benchmarking, and strong analytical skills. This role involves collaboration with Finance leadership to implement solutions optimizing operations. Occasional travel is required. The compensation range is $94,900 - $130,500 annually, with additional bonuses and comprehensive benefits.
#J-18808-Ljbffr
$94.9k-130.5k yearly 4d ago
Director, Transformation Management Office
Healthcare Services 4.1
Remote
Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Description:
Director, Transformation Management Office
3M Health Care is now Solventum
At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.
We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.
The Impact You'll Make in this Role
The Director, Transformation Management Office (TMO) will be responsible for driving large-scale transformation initiatives to drive organizational change and achieve strategic objectives, including end to end projects such as large-scale organizational transformation projects, enterprise financial modernization projects, and process improvement initiatives. Additional objectives will be continually evaluated across the TMO. These are mission critical objectives for the organization which are of high visibility and risk/opportunity for the company. Significant executive interaction is required in this role. This role will report to a Vice President, Transformation Management Office.
The ideal candidate will possess strong program management skills, a high degree of business acumen in interacting with cross-functional teams and executive leaders, excellent communication skills, and a proven track record leading large scale transformation initiatives.
As Director, Transformation Management Office, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:
Lead Transformation Initiatives: Oversee major transformation projects, ensuring alignment with organizational objectives and delivering measurable outcomes.
Program Planning: Collaborate with business owners and stakeholders to define program strategy and roadmap and manage execution.
Stakeholder Management and Engagement: Build strong relationships with senior leaders and internal and external stakeholders to ensure alignment, buy-in, and support for transformation initiatives.
Performance Monitoring: Establish metrics and KPIs to track the progress and success of transformation projects. Manage tooling and reporting mechanisms.
Risk Management: Identify and mitigate risks associated with transformation projects.
Executive Acumen and Collaboration: Gravitas and ability to interact with the most senior leaders of the organization is critical.
Change Agent: Act as a key voice for change, helping to engage and align teams around achieving transformation goals and performance metrics.
ProjectManagement: Drive overall cross-functional projectmanagement of transformation initiatives, including managingproject plan, deliverables, owners and due dates, RAIDE Register (Risks, Assumptions, Issues, Dependencies, and Escalations), etc
Your Skills and Expertise
To set you up for success in this role from day one, Solventum requires the following qualifications:
Bachelors degree or higher in Business Management, or a related field and minimum 10 years of experience in transformation management, with a proven track record of leading large-scale initiatives.
Prior experience in management consulting at a top-tier firm is preferred, with a preference for healthcare/Medtech experience
Excellent leadership, communication, presentation, and interpersonal skills, with ability to work collaboratively with executive and senior leadership and effectively build business relationships and influence without authority as part of a matrix organization
Strategic Thinking: Ability to think strategically and develop innovative solutions.
Analytical Skills: Excellent analytical and problem-solving skills.
ProjectManagement: Expertise in projectmanagement methodologies and tools.
In addition to the above requirements, the following are also required:
Transformation principles: knowledge and/or experience with agile/lean process preferred
Collaborative Approach: Strong collaboration and teamwork skills.
Results oriented, hands-on, and able to roll-up their sleeves to drive completion of necessary tasks
Adaptability: Ability to navigate and manage change in a fast-paced environment.
Proven track record of driving successful transformation initiatives with high impact results and working collaboratively in cross-functional teams, with preference on global organizations and enterprise-wide transformations
Self-motivated, high energy, respectful, honest, hard-working and loyal team member
Work location: Remote - United States
Travel: May include up to [25%][domestic/international]
Relocation Assistance: No
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).
Supporting Your Well-being
Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.
Applicable to US Applicants Only:The expected compensation range for this position is $211,600 - $290,950, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: *************************************************************************************** of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.
Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.
Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.
Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.
Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.
Solventum Global Terms of Use and Privacy Statement
Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms.
Please access the linked document by clicking here. Before submitting your application you will be asked to confirm your agreement with the
terms.
$211.6k-291k yearly Auto-Apply 3d ago
Strategy & Operations Lead - Provider Practice Management
Humana 4.8
Springfield, IL jobs
**Become a part of our caring community and help us put health first** We are looking for a dynamic Strategy & Operations Lead - Provider Practice Management to develop clinical solutions for our members and providers, with full accountability from strategy to execution.
The Strategy & Operations Lead - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team within Clinical Strategy and Analytics. This role is not a traditional software product manager role. Instead, it requires demonstrated expertise in healthcare delivery, provider performance improvement, operational redesign, and translating insights into actionable workflows for clinical practices.
The Strategy & Operations Lead - Provider Practice Management will work across clinical initiatives focused on reducing 30-day Plan All-Cause Readmissions (PCR). They will partner closely with high-performing and low-performing provider groups to identify clinical best practices, understand operational gaps, and design and operationalize provider-facing improvements that lead to measurable performance lift. They must be highly collaborative, able to work cross-functionally across Humana and external provider partners, and able to drive execution (not just strategy) in a fast-moving environment.
**Key responsibilities of the position are as follows:**
Best Practice Identification
+ Engage with high-performing provider groups to understand clinical workflows, transitional care processes, and operational drivers that contribute to lower readmission rates.
+ Conduct targeted discovery with low-performing providers to identify barriers, workflow breakdowns, staffing constraints, or data usability issues that inhibit execution of best practices.
+ Translate field insights into a clear set of best practices and operational playbooks that provider organizations can adopt to meaningfully reduce readmissions.
Product & Insight Development
+ Partner with Clinical Analytics to understand key data patterns and root causes of readmissions and convert these signals into provider-friendly insights.
+ Lead the design and refinement of provider-facing data views (dashboards, insights, performance summaries) to ensure they are actionable, timely, and aligned to provider workflows.
+ Work with product leads and data teams to prioritize enhancements that make insights easier for providers to use - e.g., surfacing patients most likely to readmit, highlighting missed touchpoints, or flagging operational risk.
Execution With Providers & Internal Stakeholders
+ Serve as the primary operational liaison with targeted provider groups, ensuring best practices are activated and sustained.
+ Co-develop and support rollout of interventions such as transitional care workflows, follow-up protocols, huddle tools, or care-team guidance that directly reduce readmission risk.
+ Work with enterprise partners (e.g., care management, clinical programs, analytics, population health) to ensure alignment and remove operational barriers to provider adoption.
Strategy & Impact Measurement
+ Define the strategic roadmap for provider practice improvements related to PCR.
+ Set measurable targets, track provider engagement, and monitor performance lift over time.
+ Synthesize complex clinical, operational, and analytic information into clear recommendations for executive leadership.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ 7 or more years of experience in population health strategy, health outcomes strategies and/or provider practice management OR 3 years of management consulting with additional 2-3 years of professional work experience
+ Strong understanding of transitional care management
+ Experience working directly with provider groups, clinical leaders, or care teams
+ Experience in advanced primary care or high-performance provider model organizations (e.g., ChenMed, Oak Street, Cityblock, Iora, CareMore)
+ Strong data literacy with demonstrated experience using analytics to drive operational insights
+ Excellent communication, relationship-building, and cross-functional collaboration skills
+ Ability to independently manage complex initiatives, work across departments, and drive execution without day-to-day oversight
**Preferred Qualifications**
+ Background as a clinician (RN, NP, PA, MD, PharmD, or similar)
+ Experience with population health workflows and drivers of 30-day readmissions
+ Experience in management consulting and clinical practice (ideal but not required)
+ Expertise in provider workflow optimization, care transitions, or readmission reduction programs
+ Familiarity with EHR workflows and system integrations
+ Demonstrated ability to translate analytics into operationally executable solutions
**Additional Information**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$126,300 - $173,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-08-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$126.3k-173.7k yearly Easy Apply 59d ago
Government Programs Care Manager III (Peoria , IL)
Encore- Business Project Director, Enterprise Site Optimization
Cigna Group 4.6
Homestead, MO jobs
Business Project Director, Enterprise Site Optimization -Encore (Cigna Retiree Program)
As a Business Project Director, you'll drive strategic initiatives that fuel our growth and operational excellence. Join a team of ambitious, compassionate experts who believe in the power of collaboration, innovation, and continuous improvement. If you thrive in dynamic environments and are passionate about making a meaningful difference, we want to meet you.
Responsibilities
Champion the development and execution of large-scale, cross-functional business projects that align with Evernorth's strategic vision and deliver measurable outcomes.
Partner with senior leaders to shape project priorities, investment decisions, and long-term goals.
Translate strategic objectives into actionable project plans, roadmaps, and clear success metrics.
Lead and inspire cross-functional teams (operations, real estate, technology, IT, HR, and more) to achieve coordinated execution and breakthrough results.
Monitor project performance, proactively manage risks, and implement solutions to ensure projects are delivered on time and within scope.
Foster a culture of continuous improvement by optimizing processes, workflows, and resource utilization.
Serve as the central point of contact for executives and stakeholders, delivering clear updates, insights, and recommendations.
Coach, mentor, and develop a team of 3-6 direct reports, empowering them to grow and excel.
Identify and champion opportunities to enhance project methodologies, tools, and execution frameworks.
Support ad hoc needs as identified by Evernorth Fulfillment leadership.
Qualifications
Required
8+ years of experience leading complex business, operational, or transformational projects, with a proven record of success in strategic and operational leadership.
Demonstrated ability to manage and motivate cross-functional teams in fast-paced, dynamic, and sometimes ambiguous environments.
Strong leadership, strategic thinking, and decision-making skills.
Excellent communication, negotiation, and stakeholder management abilities.
Proficiency in interpreting data, financial models, and KPIs to drive business outcomes.
High adaptability and problem-solving skills, with the ability to resolve issues and generate results among diverse groups.
Exceptional organizational skills, with the capacity to manage multiple priorities simultaneously.
Willingness to travel overnight up to 25%.
Preferred
Bachelor's degree in Business, Management, Finance, Operations, or a related field; Master's degree preferred.
Experience with MS Office (including Excel, Visio, PowerPoint) and MS Project.
Experience operating within a complex, matrixed organization.
Strong technical understanding to assess value, prioritize initiatives, and solve critical problems.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
This position will oversee the development and execution of end-to-end revenue cycle service commitments for one or more of Optum's Health System partnerships. The role will continuously drive client revenue cycle performance improvement, as well as cost, productivity, and profitable goals. Success depends on driving efficiency, effective partnership, influence, and collaboration across various functions of Optum Insight ensuring initiatives and strategy are targeting delivery of world-class billing services, driving patient and customer commitment, and maximizing return through improved bad debt, cash realization, and cost efficiencies. This position is responsible for influencing change related to the key functions of Revenue Cycle through collaborative engagement with various matrixed teams to develop and support innovative initiatives that will achieve optimal results while identifying gaps in client support/performance and proposing solutions (technology, services) to drive performance improvement.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
**Primary Responsibilities of CDL role will focus on four key areas:**
The Client Delivery Lead (CDL), Revenue Cycle Management is an operations leader who has direct accountability for P&L performance, KPIs, and all functions in Front, Middle, and Back Revenue Cycle Management (RCM) Operations supporting Market Performance Partnership (MPP) clients. The position achieves successful outcomes by working across a matrix environment to drive cost performance, productivity, and growth while ensuring successful delivery on end-to-end performance requirements for revenue cycle management clients.
+ Operations
+ Provide direction, oversight, and monitoring of RCM performance on a daily, weekly, monthly, and quarterly cadence
+ Deliver updates to clients and Centers of Excellence (COEs) as necessary
+ Proactively raise concerns with clients, COEs, and delivery teams, influencing change to drive action and improvement
+ Celebrate successes across clients, COEs, and delivery teams
+ Perform regular analysis of performance, including industry metrics, client metrics, SLAs, and incentive programs
+ Inform Client Relationship Executives (CREs) and other stakeholders regularly
+ Client Partnership
+ Partner and build trust-based relationships with client CFOs and other relevant client leaders
+ Provide guidance and advice on the impact of industry changes, revenue impact of client strategic plans, payer contracting and other relevant topics
+ "Walk the halls" to understand client operations, challenges, and successes
+ Performance Improvement
+ Plan and manage overall client and Optum RCM strategy to ensure SLA adherence, achieve incentive goals, and deliver high client performance
+ Develop, execute and monitor projects and technology introduction to improve client performance, operational efficiency/productivity and growth
+ Guide change management across diverse client and Optum teams
+ Serve as a creative thought leader, comfortable leading in ambiguity and influencing positive outcomes in a matrixed environment
+ People Management
+ Manage patient access and other on-site teams, ensuring alignment with client and organizational goals
+ Ensure tight collaboration, communications and relationships between on-site, remote domestic and global teams supporting client revenue cycle services
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ 7+ years of RCM Operations leadership experience overseeing Front, Middle, and/or Back
+ 7+ years of client management/consulting experience within healthcare delivery systems, interfacing with enterprise-level executives
+ 5+ years planning and managing overall RCM strategy to ensure SLA adherence, incentive goals, and client performance
+ Demonstrated experience driving projects and introducing technology to improve client performance and operational efficiency
+ Proven ability to analyze complex market opportunities and develop creative solutions
+ Demonstrated experience facilitating organizational change and providing process improvement recommendations
+ Travel up to 25% of the time on a sustained basis
**Preferred Qualifications:**
+ Advanced Degree (MBA, MHA, or equivalent)
+ Experience working within a global organization
+ Experience managing and supporting organizational change
+ Proven excellent communication, leadership, customer service, and problem-solving skills
+ Local to Minneapolis, MN
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 to $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$47k-67k yearly est. 16d ago
Client Delivery Lead - Revenue Cycle Management
Unitedhealth Group Inc. 4.6
Plymouth, MN jobs
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position will oversee the development and execution of end-to-end revenue cycle service commitments for one or more of Optum's Health System partnerships. The role will continuously drive client revenue cycle performance improvement, as well as cost, productivity, and profitable goals. Success depends on driving efficiency, effective partnership, influence, and collaboration across various functions of Optum Insight ensuring initiatives and strategy are targeting delivery of world-class billing services, driving patient and customer commitment, and maximizing return through improved bad debt, cash realization, and cost efficiencies. This position is responsible for influencing change related to the key functions of Revenue Cycle through collaborative engagement with various matrixed teams to develop and support innovative initiatives that will achieve optimal results while identifying gaps in client support/performance and proposing solutions (technology, services) to drive performance improvement.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities of CDL role will focus on four key areas:
The Client Delivery Lead (CDL), Revenue Cycle Management is an operations leader who has direct accountability for P&L performance, KPIs, and all functions in Front, Middle, and Back Revenue Cycle Management (RCM) Operations supporting Market Performance Partnership (MPP) clients. The position achieves successful outcomes by working across a matrix environment to drive cost performance, productivity, and growth while ensuring successful delivery on end-to-end performance requirements for revenue cycle management clients.
* Operations
* Provide direction, oversight, and monitoring of RCM performance on a daily, weekly, monthly, and quarterly cadence
* Deliver updates to clients and Centers of Excellence (COEs) as necessary
* Proactively raise concerns with clients, COEs, and delivery teams, influencing change to drive action and improvement
* Celebrate successes across clients, COEs, and delivery teams
* Perform regular analysis of performance, including industry metrics, client metrics, SLAs, and incentive programs
* Inform Client Relationship Executives (CREs) and other stakeholders regularly
* Client Partnership
* Partner and build trust-based relationships with client CFOs and other relevant client leaders
* Provide guidance and advice on the impact of industry changes, revenue impact of client strategic plans, payer contracting and other relevant topics
* "Walk the halls" to understand client operations, challenges, and successes
* Performance Improvement
* Plan and manage overall client and Optum RCM strategy to ensure SLA adherence, achieve incentive goals, and deliver high client performance
* Develop, execute and monitor projects and technology introduction to improve client performance, operational efficiency/productivity and growth
* Guide change management across diverse client and Optum teams
* Serve as a creative thought leader, comfortable leading in ambiguity and influencing positive outcomes in a matrixed environment
* People Management
* Manage patient access and other on-site teams, ensuring alignment with client and organizational goals
* Ensure tight collaboration, communications and relationships between on-site, remote domestic and global teams supporting client revenue cycle services
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* 7+ years of RCM Operations leadership experience overseeing Front, Middle, and/or Back
* 7+ years of client management/consulting experience within healthcare delivery systems, interfacing with enterprise-level executives
* 5+ years planning and managing overall RCM strategy to ensure SLA adherence, incentive goals, and client performance
* Demonstrated experience driving projects and introducing technology to improve client performance and operational efficiency
* Proven ability to analyze complex market opportunities and develop creative solutions
* Demonstrated experience facilitating organizational change and providing process improvement recommendations
* Travel up to 25% of the time on a sustained basis
Preferred Qualifications:
* Advanced Degree (MBA, MHA, or equivalent)
* Experience working within a global organization
* Experience managing and supporting organizational change
* Proven excellent communication, leadership, customer service, and problem-solving skills
* Local to Minneapolis, MN
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 to $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$47k-67k yearly est. 8d ago
Program Manager III - Healthcare Transformation
Centene 4.5
Remote
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Promote increased program efficiency, service levels, and value by capturing and monitoring performance, and then identifying opportunities for improvement and strategies to realize those opportunities. Plan, organize, monitor, oversee and lead multiple, concurrent resultant projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.
Responsible for managing a portfolio of cross functional healthcare transformation initiatives that align with company goals and drive results
Lead the ideation and identification of initiatives to increase efficiency, improve service levels, and innovate
Identify impacts, risks and interdependencies and support development and make recommendations to senior leadership based on findings
Develop strategies to realize improvement opportunities, and ensure organizational prioritization and resource alignment
Monitor initiatives to drive performance and analyze data to determine trends and opportunities
Ideate and identify initiatives for the portfolio
Manage multiple projects through full project life cycle process including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure
Utilize corporate and industry standard projectmanagement tools and techniques to effectively manageprojects
Maintain detailed project documentation as needed including action items, issues lists and risk mitigation plans
Provide leadership and effectively communicate project status to all stakeholders, including executive summaries and presentations
Negotiate with project stakeholders to identify and secure resources, resolve issues, and mitigate risks
Lead cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives
Provide functional and technical knowledge regarding overall program requirements and operations
Education/Experience: Bachelor's degree in Business Administration, Healthcare Administration, related field, or equivalent experience. Master's degree preferred. 5+ years project implementation, product or program management experience. Managed care or prescription benefit management experience preferred.Pay Range: $87,700.00 - $157,800.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$87.7k-157.8k yearly Auto-Apply 10d ago
Program Manager II
Centene 4.5
Remote
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Plan, organize, monitor, and oversee programs to improve quality for Nevada Medicaid by utilizing cross functional teams, including external provider partners, to deliver defined requirements and meet business needs and strategic objectives for Silver Summit Health Plan.
*** The Program Manager II is primarily remote with 25% travel expectation. Candidates must reside within the state of Nevada, preferably Las Vegas, and hold a valid driver's license to be considered for the position. ***
Responsibilities:
Support quality improvement department initiatives that promote quality, safety, and cost of care opportunity.
Responsible for gathering requirements, creating plans and schedules, managing resources, and facilitating project execution and deployment.
Utilize corporate and industry standard tools and techniques to effectively oversee programs according to department procedures.
Maintain detailed business process documentation including meeting minutes, action items, issues lists and risk management plans as applicable.
Create and monitor all department deliverables to ensure adherence to quality standards including clinical reporting documents, related reference materials, and policy and procedure documentation.
Communicate program status to management and key stakeholders.
Identify resources, resolve issues, and mitigate risks.
Identify requirements, procedures, and problems to improve existing processes.
Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and business objectives.
Manageprojects through the full project life cycle.
Provide leadership and effectively communicate project status to all stakeholders.
Negotiate with project stakeholders to identify and secure resources, resolve issues and mitigate risks.
Perform other duties as assigned.
Comply with all policies and standards.
Education/Experience: Bachelor's Degree in related field or equivalent experience required. 3+ years of quality improvement, program management or projectmanagement experience required. Health care experience, specifically with value-based, quality, risk adjustment highly preferred.
Pay Range: $70,100.00 - $126,200.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$70.1k-126.2k yearly Auto-Apply 4d ago
Government Program Care Manager III - 743
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This is a Union RoleJob SummaryThis position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations.
Required Job Qualifications:
Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
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 direct clinical experience.
Patient education experience.
Condition Management experience.
Bilingual in English and Spanish.
Experience in managing complex or catastrophic cases.
Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.
Government Programs experience
Population Management
This is a Union role. This is a Union Telecommute (Remote) role. Must reside within a 60-mile radius of the Chicago office
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$34.90 - $57.89
Exact compensation may vary based on skills and experience.
$34.9-57.9 hourly Auto-Apply 52d ago
Government Programs Care Manager III
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations
Required Job Qualifications:
* Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
* 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 direct clinical experience.
* Patient education experience.
* Condition Management experience.
* Bilingual in English and Spanish.
* Experience in managing complex or catastrophic cases.
* Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.
* Government Programs experience
* Population Management
This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting **************************************
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$26.37 - $58.19
Exact compensation may vary based on skills, experience, and location.
$26.4-58.2 hourly Auto-Apply 60d ago
Government Programs Care Manager III
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job SummaryThis position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations.
Required Job Qualifications:
Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
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 direct clinical experience.
Patient education experience.
Condition Management experience.
Bilingual in English and Spanish.
Experience in managing complex or catastrophic cases.
Certification in Case Management, Training, ProjectManagement or nationally recognized health care certification.
Government Programs experience
Population Management
This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.
This role requires travel to members in the following cites: Waterloo, Cahokia, Freeburg, and Columbia IL
#LI-AC1
#LI-Hybrid
#CA
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting **************************************
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$26.37 - $58.19
Exact compensation may vary based on skills, experience, and location.
$26.4-58.2 hourly Auto-Apply 60d+ ago
Government Programs Care Manager III (Belleville, IL)
HCSC 4.5
Senior project manager job at HCSC
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations
Required Job Qualifications:
* Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
* 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 direct clinical 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, Training, ProjectManagement or nationally recognized health care certification.
* Government Programs experience
* Population Management
This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting **************************************
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$26.37 - $58.19