Utilization Management Coordinator - RN – MONDAY THROUGH FRIDAY/TELECOMMUTER (ABQ)

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 Summary

This 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. This position reviews service requests, 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, and provides information regarding utilization management requirements and operational procedures to members, providers and facilities.

**THIS IS A TELECOMMUTER ROLE FOR THE ALBUQUERQUE HEADQUARTERS OFFICE. YOU MUST BE WILLING AND ABLE TO WORK IN THE OFFICE 6 MONTHS (FOR TRAINING) BEFORE YOU CAN FULLY TELECOMMUTE.
**WORK HOURS: MONDAY THROUGH FRIDAY 8 AM - 5 PM.

JOB REQUIREMENTS:
* Registered Nurse (RN) with valid, current, unrestricted license in the state of operations (New Mexico).
* 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.


PREFERRED JOB REQUIREMENTS:
* Utilization management experience.
* MCG Certification.

The Compensation/Salary offered will vary depending on Job-related skills, education, knowledge and experience. This role aligns with an Annual Incentive Bonus plan.

#LI-Remote

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position.

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 Apply