Utilization Management Coordinator (HAS)
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.
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Job SummaryThis position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility, Determines benefit levels in accordance to contract guidelines. Prepares reports on quality of care, identifies and reports cases. Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. Willingness and ability to travel.JOB REQUIREMENTS:
Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.
3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company.
Knowledge of medical terminology and procedures.
Verbal and written communication skills.
Willingness and ability to travel.
PREFERRED JOB REQUIREMENTS
RN with compact license
Utilization management experience.
MCG Certification.
This position is remote
Work schedule - Monday thru Friday 9:30 AM to 6:00 PM
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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
Ability to travel Must have valid RN license Willingness to travel
Benefits/PerksCurated development plans Employee Referral Process Growth Opportunities Inclusive workplace Professional development Purpose-driven company Purpose-driven environment Remote work
Tasks- Care coordination
- Concurrent review activities
- Data Collection
- Eligibility verification
- Initial review activities
- Report preparation
- Utilization Management
Business Care Coordination Clinical Data Collection Clinical Experience Communication Health care Insurance Management MCG Certification Medical terminology Registered Nurse RN Utilization management Verbal communication Written communication
Experience3 years
Education CertificationsMCG MCG Certification Registered Nurse
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