Care Management Specialist II
Job ID: FIW-1019278 Description:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can email us here to request reasonable accommodations.
Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".
This position is responsible for discharge care coordination, episodic case management and pre-admission/post-discharge counseling for an acute condition. This position is responsible for handling duties in an independent manner and may assist other staff. 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. Determine case complexity and refer to other internal departments as needed.
- Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with current, active, unrestricted license in the state of operations (or reciprocity if applicable).
- 2 years clinical experience.
- 1 year health insurance/managed care experience.
- Knowledge of medical management policies and procedures.
- PC and database experience.
- Verbal and written communication skills.
- Customer service skills and interpersonal skills to discuss pre/post admission care with physicians, hospital staff and members.
- Ability and willingness to occasionally travel within assigned location. Possess transportation and current, valid driver's license for applicable state.
PREFERRED JOB REQUIREMENTS:
- 3 or more years clinical experience.
- Familiarity with ancillary services including but not limited to Home Health Care (HHC) or Skilled Nursing Facility (SNF).
- Familiarity with Utilization Management/Case Management activities and standardized criteria sets.
Requirements: Expertise Nursing Job Type Full-Time Regular Location TX - Richardson
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