Integrated Care Manager

Qualifications

• Requirements and Preferences:
• Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), 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 3 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.
• 3 years of wellness or managed care experience presenting clinical issues with members/physicians.
• Demonstrates strong clinical knowledge, ability to perform clinical assessments on Cardiology patients, ability to use critical thinking skills and has the capacity for continued learning.
• Knowledge of UM and plan benefit designs.
• Demonstrated ability to perform case management & disease management activities.
• Ability to demonstrate knowledge of and apply those to the job function and responsibilities.
• Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.
• Verbal and written communication skills including listening, discussing and documenting medical needs with members, providers, internal staff/management, external vendors, and community resources.
• PC proficiency to include Word, Excel, PowerPoint, database experience and Web based applications.
• Current driver’s license, transportation and applicable insurance.
• Ability and willingness to travel within assigned territory.

• Preferred Skills
• UM, CM or DM experience with a Managed Care Organization (MCO)
• Patient education experience.
• Bilingual – English and Spanish
• Knowledge of the health and wellness marketplace and employer trends.
• Experience in managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management or nationally recognized health care certification.
• Personal management skills — Plan and manage multiple assignments and tasks, set priorities and adapt to changing conditions and work assignments. Teamwork —ability to work well with one or more groups.
• Interpersonal effectiveness — Relate to co-workers and build relationships with others in the organization.
• Strong work values — Dependability, honesty and a positive attitude.