[Hiring] Case Management Coordinator II @Health Care Service Corporation

Role Description

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. Responsibilities include:

• Consulting with physicians, providers, members, and other resources 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.
• Performing face-to-face visits in San Antonio and providing telephonic support for all other locations.
• Ability and willingness to travel within assigned location.

Qualifications

• Registered 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.

Requirements

• 3 years clinical experience (preferred).
• Medicare knowledge a plus.
• 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 (not required but a plus).

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• A minimum of 15 days of paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Other incentives.

Pay Transparency Statement

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

Min to Max Range: $69,800.00 - $125,900.00

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