Holistic Health Specialist

🕒 July 17

🌽 Illinois, New Mexico, +2 more states – Remote

🌽 Illinois – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote

💵 $61.5k - $136.1k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🦅 H1B Visa Sponsor

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Serve as a single source of contact for members, health care personnel, and other entities involved in managing care • Identify alternate treatment programs and evaluate options and services needed to meet individual health needs • Consult with physicians, providers, members, and other resources • Promote quality and cost-effective outcomes and serve as a liaison to physicians and members • Determine member assignment of treatment • Provide pre-admission and post-discharge counseling for acute conditions • Establish relationships with members • Handle immediate post-discharge follow-up until short-term care needs are met • Provide education and local resource information and encourage member self-education • Assess members for wellness education and disease management • Introduce members to website tools and educate them about wellness and specific conditions • Facilitate coordination of care for identified members • Provide oversight to holistic health coordinators

🎯 Requirements

• Registered Nurse (RN) with current, valid, unrestricted license in state of operations • 2 years of clinical practice experience providing direct clinical care to the customer • 1 year of experience in care management/condition management in a health insurance/managed care setting • PC proficiency including Word, Excel, Lotus Notes, and database experience • Clear and concise verbal and written communication skills • Familiarity with ancillary services including HHC, SNF, Hospice, etc. • Analytical skills • Decision-making skills and sound clinical judgment to provide oversight of other staff • Active and unrestricted Compact Nursing license • Case Management experience • Experience managing complex or catastrophic health cases • Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, or obstetric management • Working toward or completion of CCM/CCP/CDE/MCG certification or advanced degree is preferred • Knowledge of Milliman Guidelines or similar clinical guidelines is preferred • Knowledge of medical management policies and procedures is preferred • Willingness to work Central Standard Time hours, 9:30 AM to 6 PM CST, Monday through Friday • Sponsorship is not available

🏖️ Benefits

• Curated development plans that foster growth and promote rewarding, fulfilling careers • Annual incentive bonus plan • Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Reasonable accommodations or assistance during the application process