Care Management Specialist

The Care Management Specialist is responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues. The MSS is responsible for supporting the management of complex medical cases and health care needs across the continuum of care using the care management process to ensure optimal care, services, and provides care coordination for members.

Minimum: Degree in nursing or health related professional with a certification or licensure. Four to six years of clinical experience in a variety of health care settings, including three to four years working in a managed care setting. Registered Nurse licensure or Masters-level behavioral health licensure therapist.