Case Management Coordinator II

Posted 3 Days Ago
Be an Early Applicant
Richardson, TX
60K-133K Annually
Mid level
Healthtech • Insurance
The Role
The Case Management Coordinator II performs concurrent review and discharge planning, identifying cost-effective treatment options and consulting with healthcare providers to coordinate services. This role includes assessing health needs, serving as a liaison, and providing support to less experienced staff.
Summary Generated by Built In

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 accepted department criteria; performing discharge planning and identifying alternate treatment programs that provide medically necessary potentially cost-effective services. Consulting with physicians, providers, members, and other resources, as appropriate, 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.

JOB REQUIREMENTS:

  • 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.

PREFERRED JOB REQUIREMENTS:

  • 3 years clinical experience.
  • 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.

#LI-REMOTE

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 / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, 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$60,300.00 - $133,400.00

The Company
HQ: Chicago, IL
13,563 Employees
On-site Workplace

What We Do

Imagine Something New, Something Different.

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families.

HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development.

HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC.

Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization.



Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

Similar Jobs

Cloudflare Logo Cloudflare

Vice President, Revenue Enablement

Cloud • Information Technology • Security • Software • Cybersecurity
Hybrid
Austin, TX, USA
3900 Employees
340K-454K Annually

Apex Fintech Solutions Logo Apex Fintech Solutions

Business Systems Analyst

Fintech • Software • Financial Services
Hybrid
2 Locations
850 Employees

Capital One Logo Capital One

Set Up My Loan Department Operations Manager (Hybrid)

Fintech • Machine Learning • Payments • Software • Financial Services
Hybrid
Plano, TX, USA
55000 Employees
115K-132K Annually

Capital One Logo Capital One

Manager, Cyber Analytic Governance

Fintech • Machine Learning • Payments • Software • Financial Services
Hybrid
3 Locations
55000 Employees
176K-221K Annually

Similar Companies Hiring

Zealthy Thumbnail
Telehealth • Social Impact • Pharmaceutical • Healthtech
New York City, NY
13 Employees
MassMutual India Thumbnail
Insurance • Information Technology • Fintech • Financial Services • Big Data
Hyderabad, Telangana
Cencora Thumbnail
Pharmaceutical • Logistics • Healthtech
Conshohocken, PA
46000 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account