Case Management Coordinator II
Richardson Texas HQ (1001 E. Lookout Drive)
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job SummaryPosition 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.Job requirements:
- Register Nurse (RN) with current, valid, unrestricted license in state of operations (TX, OK, NM) 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 Word, Excel, Outlook 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:
- CCM Certification required.
- 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 a plus
#LI-Remote
This is a Telecommute (Remote) role for TX, OK and NM: Must reside anywhere within the posted State(s).
Sponsorship is not available.
The Compensation/Salary offered for this Position will vary depending on Job-related skills, education, knowledge and experience. This role aligns with an Annual Performance Incentive (Bonus) plan.
We encourage people of all backgrounds and experiences to apply.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$58,800.00 - $130,100.00 ApplyJob Profile
Must reside in TX, OK, NM NM OK Sponsorship not available TX
Benefits/PerksAnnual performance incentive bonus Curated development plans Employee Referral Process Inclusive workplace Multi-state license fees covered Professional development Purpose-driven company
Tasks- Case management
- Concurrent review
- Consult with physicians and providers
- Coordinate health services
- Discharge planning
- Disease management
- Implementation
- Perform concurrent review
- Planning
- Precept less experienced staff
- Serve as liaison
Bilingual Business Case Management Clinical Care Clinical Experience CM Communication Customer service Database Database experience Database Management Discharge planning Disease Management Excel Health Insurance Insurance Managed Care Management Medical management Medical Management Policies Microsoft Excel Microsoft Outlook Microsoft Word Nursing Outlook PC PC Proficiency Planning RN Word Written communication
Experience2 years
EducationAdvanced degree Business Nursing RN
CertificationsAdvanced degree CCM CCM certification RN License
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9