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 staff involved in Behavioral Health Care Utilization Management (UM) including Preauthorization, Concurrent, and Retrospective Review-- while abiding by all contractual and accreditation requirements. This position collaborates with providers to ensure services are rendered in a cost-effective manner while meeting the member’s health needs within the scope of their benefit plan. This position is responsible for assisting in developing and implementing Behavioral Health Care Policies, Procedures and Initiatives related to Behavioral Health Utilization Management Services, which includes operationalizing, monitoring and assisting the utilization management team in achieving departmental targets and goals-- evidencing optimal people/leadership skills.
JOB REQUIREMENTS:
- Registered Nurse (RN) with current, valid license in good standings or Masters-level Behavioral Health Professional with current, valid license in good standings to practice at the independent practice level in the state of Texas.
- 3 years clinical experience in psychiatric setting or own behavioral health practice.
- 3 years behavioral health utilization review or behavioral health Utilization management experience.
- Knowledge of medical terminology.
- Knowledge of accrediting agency standards and regulations.
- Knowledge of behavioral health products, processes, community services and trends.
- Leadership skills.
- Project management skills.
- Verbal and written communication skills.
- Analytical and decision making skills.
- PC and database experience.
Telecommute:
This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.
*CA
#LI-TELECOMMUTE
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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$67,500.00 - $143,100.00
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.
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