Medical Management Specialist

Medical Management & Health Education Specialist

Location:

Chicago, IL

Job Type: Contract

Expected hours per week: 40 hours per week

Schedule:

Monday – Friday, 9-5, onsite.

Pay Range: $36-38 Per Hour

This position is responsible for delivering medical management and health education programs to members enrolled in government healthcare programs. The role supports regulatory compliance through accurate data gathering and reporting and serves as a key representative of the company to its members.

• Conduct medical management and health education programs for members in government-sponsored healthcare plans
• Engage directly with members to assess medical needs and support care coordination
• Gather, analyze, and report clinical and program data for regulatory and compliance requirements
• Present and explain clinical information to members, physicians, and care teams
• Collaborate with internal staff, external vendors, and community resources to support member care
• Support wellness initiatives and condition management programs
• Maintain accurate documentation in databases and web-based applications
• Travel within the assigned territory to meet with members as needed

• One of the following licenses:
  • Registered Nurse (RN) with 3 years of direct clinical care experience in a clinical setting
  • Licensed Professional Counselor (LPC) with 2 years of clinical practice post-licensure
  • Licensed Master Social Worker (LMSW) with 2 years of clinical practice post-licensure
• Current, valid, unrestricted license in the state of operations (or reciprocity)
  • Compact RN license holders must obtain active, unrestricted state licensure within 90 days of hire if relocating
• 3 years of wellness, case management, or managed care experience
  , including interaction with members and physicians
• Knowledge of the health and wellness marketplace and employer healthcare trends
• Strong verbal and written communication skills, including discussing medical needs with members
• Experience analyzing medical and clinical data
• Valid driver’s license, reliable transportation, and required insurance
• Ability and willingness to travel within assigned territory
• PC proficiency, including:
  • Microsoft Word, Excel, and Power Point
  • Database systems and web-based applications

• Additional 3 years of clinical experience
• Patient education experience
• Condition or disease management experience
• Transition of Care experience
• Experience managing complex or catastrophic cases
• Bilingual in English and Spanish
• Certification in:
  • Case Management
  • Training
  • Project Management
  • Or another nationally recognized healthcare certification