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 supervising and monitoring the care management staff; assuring clinical accuracy of content, web and non-web based; monitoring revisions to national standards of care and assuring they are reflected in the care management program,. Developing and implementing department workflow processes that reflect positive outcomes to membership and achieve targeted metrics. Providing feedback on department processes, including quality initiatives and recommending steps for improvement; interfacing with internal/external customers; and serving as liaison between customers and the medical management department.

JOB REQUIREMENTS:

• Current, unrestricted license in the state of operations in one of the following: Registered Nurse (RN), Licensed Professional Counselor (LPC), Registered Dietician (RD), Licensed Master Social Worker (LMSW), or Licensed Clinical Social Worker (LCSW).
• 2 years’ experience with direct clinical care to the consumer.
• 2 years’ experience as a case manager.
• Project management experience.
• Knowledge of disease management and the insurance industry.
• Ability to research clinical topics.
• PC proficiency to include Word, Excel, PowerPoint and Lotus Notes.
• Analytical and problem solving skills.
• Verbal, written, and interpersonal communication skills.
• Willingness and ability to work flexible work schedules as needed.
• Case Management Certification (URAC accredited certification) or obtain URAC accredited case management certification within three year of employment if overseeing case management operations.
• 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:

• Supervisory experience.
• Bachelor degree.
• Experience with TX Medicaid.

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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 plan subject 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

$70,600.00 - $149,600.00

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