Case Management Coord II

Position can be in Richardson or Abilene, and may be eligible to work from home (WFH) after meeting training requirements per management discretion

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.

• Registered Nurse (RN) with unrestricted license in state.
• 3 years clinical practice experience.
• 1 year experience in health insurance/managed care.
• PC and database experience.
• Verbal and written communication skills.

• 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

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.
Requirements: Expertise Nursing Job Type Full-Time Regular Location TX - Abilene, TX - Richardson

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