At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
Responsible For Focusing On The Overall Health Of The Member By Assisting The Member With The Goal Of Increased Health. Overall Wellbeing By Developing A One-To-One Relationship With The Member.
Encourage Members To Utilize Appropriate Resources And Web Based Tools Available To Them To Access Information Regarding Their Condition As Well As Track Progress Towards Wellbeing Goals.
This Position Is Also Responsible For Guiding The Member Through Transitions In Care, Handling A Member *S Complex Needs As Well As Acute And Chronic Conditions.
Additionally, This Position Will Receive Referrals Focusing On Member Wellbeing; Including Diagnosis Based, Overall Medical Cost, Identified Treatment Gaps, Frequent Emergency Room Utilization, Pre-Admission / Post-Discharge Follow-Up, Etc.
Required Job Qualifications :
Registered Nurse (RN) with current, valid, unrestricted license in state of operations
2 years of clinical practice experience of direct clinical care to the consumer
1 year of experience in care management / condition management
PC proficiency to include Word, Excel, Outlook and database experience
Clear and concise verbal and written communication skills
Familiarity of ancillary services including HHC, SNF, Hospice, etc
Analytical skills
Decision making skills and sound clinical judgment to provide oversight of other staff
Preferred Job Qualifications :
3 years of clinical practice experience of direct clinical care to the consumer
Experience in managing complex or catastrophic health cases
Specialty clinical experience in intensive care medicine, orthopedic, NICU / pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management)
Working toward or completion of CCM / CCP / CDE / MCG certification or Advanced degree
Knowledge of Milliman Guidelines or similar clinical guidelines
Knowledge of medical management policies and procedures
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement :
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.
Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
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