Case Management Coordinataor I - BCBS

Job ID: PT-1019109 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".

BASIC FUNCTION:

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 to assess, plan, facilitate implementation, coordinate, monitor and evaluate options and services required to meet an individuals health needs, using communication and available resources to promote quality, cost effective outcomes; serving as liaison to providers, physicians, and members.

JOB REQUIREMENTS:

  • Register Nurse (RN) with unrestricted license in state.
  • 3 years clinical practice experience.
  • PC and database experience..
  • 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:

  • Familiarity with ancillary services including HHC, SNF.
  • Provider side insurance experience.
  • Familiarity with UM/CM activities and standardized criteria sets.

THIS IS NOT A TELECOMMUTING POSITION

  • LI CA CB

Requirements: Expertise Nursing Job Type Full-Time Regular Location OK - Tulsa


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