Case Management Coord II (FEP)
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs that provide medically necessary potentially cost-effective services. Consulting with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implementation, coordinate, monitor, and evaluate options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost effective outcomes. Serving as liaison to physicians, and members; serving as preceptor for less experienced staff.
This position is Remote / Telecommute
* Register Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.
* 2 years of clinical experience of direct clinical care to the consumer.
* 1 year experience in health insurance/managed care.
* Customer Service oriented.
* PC proficiency to include Microsoft Office and database experience.
* Clear and concise verbal and written communication skills.
* Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
PREFERRED JOB REQUIREMENTS:
* 3 years clinical experience.
* Experience in Disease Management.
* Experience in managing complex or catastrophic cases.
* Working toward CM certification or Advanced degree.
* Knowledge of medical management policies and procedures.
* Bilingual in Spanish/English
We encourage people of all backgrounds and experiences to apply.
Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.