Remote Medical Management Specialist I 29970
Company: Solving IT
Location: Atlanta
Posted on: June 24, 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. This position is remote near Farmington, NM.
Responsibilities: • Conducting medical management and health
education programs for customers on government health care
programs. • 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. 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: Solving IT, Athens , Remote Medical Management Specialist I 29970, Healthcare , Atlanta, Georgia
