Medical Management Specialist I 29963
Location: Atlanta
Posted on: June 23, 2025
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Job Description:
One of the largest health insurers in the nation is focused on
continuously building an industry-defining, world-class IT
capability. Healthcare is forever evolving, especially due to
emerging technologies, making this a great experience to add to
your resume. Come join their winning team! This contract to hire
role as a Remote Medical Management Specialist I 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 date for regulatory
reports. Perform assessments, care planning and care coordination
in the member/family home and telephonically. This position will
represent the company to members. Responsibilities: • Conducting
medical management and health education programs for customers on
government health care programs. • Accountabilities include
gathering, analyzing and providing date for regulatory reports. •
This position will represent the company to members. Job
Requirements: • 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 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. • 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. • Must reside near Santa Fe County, NM. Preferred Job
Requirements: • 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. Benefits : 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, regardless of gender. 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! Whether you're seeking your next
career challenge or aiming to stay abreast of industry trends,
Solving IT is committed to supporting your career advancement. We
actively encourage applications from all backgrounds and utilize
the most up-to-date market insights and compensation data to ensure
that you receive not just advice, but the complete Solving IT
Experience.
Keywords: , East Point , Medical Management Specialist I 29963, Healthcare , Atlanta, Georgia
