Pediatric Clinical Specialist - Registered Nurse
Job ID: KNH-1019778 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.
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PEDIATRIC CASE MANAGEMENT REQUIRED
"This position has the potential to Work From Home after applicant meets/exceeds production standards consistently for 6-9 months and with management approval. Internal HCSC candidates who currently Work From Home may continue working from home following their training and with management approval."
This position is responsible for conducting medical management and health education programs for corporate customers to influence the member's health choices and behaviors, to maintain cost containment, and to ensure appropriate services are being obtained and utilized. This position is accountable for determining if medical programs are needed (Case Management, Condition Management, Behavioral Health, Pharmacy, CCEI, LSM, SB); supporting the reporting of medical management outcomes; contributing to the development of job aids and program enhancements; and training/mentoring/providing oversight of clinical and non-clinical staff.
- Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting, with current, valid, unrestricted clinical license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN license in the state of operations within 90 days of hire.
- 2 years Case Management experience in managing complex and catastrophic cases across a pediatric population.
- Knowledge of the health and wellness marketplace and employer trends.
- Verbal and written communication skills including interfacing with internal staff/management and external vendors and community resources.
- Analytical experience including medical data analysis.
- PC proficiency to include Word, Excel, and Web based applications.
- Organizational skills for maintaining a library of interventions and outcomes.
- Knowledge of cost savings methodologies.
PREFERRED JOB REQUIREMENTS:
- 3 years clinical experience.
- Case Management Certification or other URAC recognized health care certification.
- Patient education experience.
- Bilingual in English and Spanish.
- Experience facilitating meetings.
- Experience mentoring or training other case management staff.
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 - Richardson
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