Primary Nurse Case Admin I (CM & UM Experience) at Health Care Service Corporation
Richardson, Texas, USA -
Full Time


Start Date

Immediate

Expiry Date

04 Dec, 25

Salary

60300.0

Posted On

04 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Health Insurance, Managed Care, Case Management, Excel, Analytical Skills, Lotus Notes, Clinical Care, Communication Skills, Oncology, Orthopedic

Industry

Hospital/Health Care

Description

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.
This position is responsible for performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities involved in managing care. The Primary Nurse Coordinator performs concurrent review, discharge planning and care coordination; identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs; promotes quality and cost effective outcomes; and serves as liaison to physicians and members. Other functions also include episodic case management, determining member assignment of treatment, and pre-admission/post-discharge counseling for an acute condition. Establish relationship with the member through the immediate post discharge follow-up period or until all short term care needs are met. Provide education/local resource information and encourage member (self) education. Functioning in a clinical care advisory role, the Primary Nurse Coordinator assesses members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members.

Responsibilities

LI-DP1

LI-Remote

CA

Compensation: $60,300.00 - $133,400.00
Exact compensation may vary based on skills, experience, and location

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