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.

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 will provide telephonic support for all other locations.

JOB REQUIREMENTS:

• 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 Word, Excel, Lotus Notes 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 or Polish/English.

This is a Telecommute (Remote) role:  Must reside within 250 miles of the office or anywhere within the posted state. 

Compensation: $60,300.00 - $133,400.00

Exact compensation may vary based on skills, experience, and location

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.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards