Remote Medical Management Specialist I 29969
Company: Solving IT
Location: Atlanta
Posted on: June 25, 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 Gallup, 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 29969, Healthcare , Atlanta, Georgia
