Job Summary

A health insurance provider needs applicants for an opening for a .

Core Responsibilities Include:

• Working with members, their providers and applicable care teams to develop personal care plans associated with medical, behavioral and/or social situations
• Conducting outbound interventions to advance member care plans, coordinate care and close clinical gaps
• Participating in the development of operating models to execute clinical program solutions, including but not limited to Complex Case Management, Disease Management and Transitions of Care

Qualifications Include:

• Bilingual in Spanish
• Bachelor’s Degree in a related field
• Three (3) or more years of clinical or case management experience preferred
• Prior experience with URAC accreditation preferred
• Ability to evaluate complicated problems and isolate contributing factors
• Active, unrestricted Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Master Social Worker (LMSW), or Licensed Clinical Social Worker (LCSW) license