Primary Nurse Case Admin 1

🔥 12 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $61.5k - $136.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

📋 Description

• Performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM). • Serving as the single source of contact for members, health care personnel and all other entities involved in managing care. • Performing concurrent review, discharge planning and care coordination. • Identifying alternate treatment programs and consulting with physicians, providers, members, and other resources. • Promoting quality and cost-effective outcomes. • Serving as liaison to physicians and members. • Establishing relationships with members through the immediate post-discharge follow-up period or until all short-term care needs are met. • Providing education/local resource information and encouraging member (self) education. • Functioning in a clinical care advisory role assessing members for wellness education and disease management.

🎯 Requirements

• Registered Nurse (RN) with current, valid, unrestricted license in state of operations • 2 years clinical practice experience of direct clinical care to the customer • 1 year experience in Condition Management or Case Management in a health insurance, managed care, physician office or hospital setting. • PC proficiency to include Word, Excel, Lotus Notes and database experience • Clear and concise verbal and written communication skills • Knowledge of UM/CM/DM activities and standardized criteria set • Familiarity of ancillary services including HHC, SNF, Hospice, etc • Verbal and written communication skills; analytical skills; sound clinical judgment • 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.

🏖️ Benefits

• Health insurance • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement