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Salary
$62k – $136k per year
Location
Remote (United States)
Seniority
Middle · 3+ years exp
Employment
Full-Time
Overview
Company
Impact
Profile match
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members.

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 for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan.

JOB REQUIREMENTS:

* Registered Nurse (RN) with current, valid, unrestricted license to practice in state of operations.

* 3 years clinical practice experience.

* Experience utilizing various software packages.

* Verbal and written communication skills.

* Analytical 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:

* Familiarity with UM/CM activities and standardized criteria set.

* Familiarity with NFLOC (Nursing Facility Level of Care) for New Mexico Medicaid

* Familiarity with LTSS (Long Term Support Services) for New Mexico Medicaid

* Proficiency in MS Office Products: Word, Excel, PPT, Outlook, etc.

#LI-MC1 #INKT

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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

$61,500.00 - $136,100.00

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

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