Holistic Health Specialist (Employee Retirement Systems)

Health Care Service Corporation; Town of Texas, Houston (WI, TX); Remote; USD 60,000 - 134,000; Full time

Job summary

Join a purpose-driven company that values employee development and offers a remote position for a Registered Nurse. In this role, you'll be the key contact for members and healthcare providers, ensuring quality care management and education. You'll assess individual health needs, coordinate care, and support wellness initiatives. This innovative firm provides a comprehensive benefits package and a competitive salary range, making it an exciting opportunity for dedicated professionals looking to make a significant impact in healthcare.

Benefits

Health and Wellness Benefits

401(k)

Pension

Paid Time Off

Parental Leave

Disability Insurance

Life Insurance

Employee Assistance

Tuition Reimbursement

Qualifications

• Must have a current RN license in the state of operations.
• 2+ years of clinical practice experience required.

Responsibilities

• Serve as a single point of contact for members and healthcare personnel.
• Promote quality and cost-effective outcomes in care management.

Skills

Registered Nurse (RN)

Clinical Practice Experience

Care Management

Communication Skills

Analytical Skills

Decision-Making Skills

PC Applications Proficiency

Education

Registered Nurse License

Tools

Word

Excel

Lotus Notes

Database Management

Job description

At HCSC, our employees are the cornerstone of our business and the foundation of 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 invests in your professional development.

Job Summary

This position is responsible for performing a variety of functions and serves as the single point of contact for members, healthcare personnel, and other entities involved in managing care. The role involves identifying alternative treatment programs, consulting with physicians, providers, members, and other resources to evaluate options and services needed to meet individual health needs. The position promotes quality and cost-effective outcomes, acts as a liaison to physicians and members, and includes responsibilities such as determining member treatment assignments, pre-admission and post-discharge counseling for acute conditions, establishing relationships with members, and handling immediate post-discharge follow-up until short-term care needs are met. It also involves providing education and local resource information, encouraging member self-education, assessing members for wellness education and disease management, introducing members to website tools, educating on wellness and specific conditions, and facilitating care coordination. Oversight of holistic health coordinators is also part of the role.

Job Requirements

• Registered Nurse (RN) with a current, valid, unrestricted license in the state of operations
• At least 2 years of clinical practice experience providing direct clinical care to customers
• At least 1 year of experience in care management or condition management within a health insurance or managed care setting
• Proficiency in PC applications including Word, Excel, Lotus Notes, and database management
• Excellent verbal and written communication skills
• Familiarity with ancillary services such as HHC, SNF, Hospice, etc.
• Strong analytical skills
• Decision-making skills and sound clinical judgment to oversee staff

Preferred Job Requirements

• Experience in case management
• Experience managing complex or catastrophic health cases
• Specialty clinical experience in areas such as intensive care, orthopedics, NICU/pediatrics, oncology, diabetic management, or obstetrics (low to high risk maternity)
• Working towards or completion of certifications like CCM, CCP, CDE, MCG, or an advanced degree
• Knowledge of Milliman Guidelines or similar clinical guidelines
• Understanding of medical management policies and procedures

#LI-DP1

#LI-REMOTE

This is a remote role: Must reside within 250 miles of the office or within the posted state.

Referral Process: If referred, ask your connection at HCSC about our Employee Referral process.

Pay Transparency: We offer a comprehensive benefits package including health and wellness benefits, 401(k), pension, paid time off, parental leave, disability insurance, life insurance, employee assistance, holidays, tuition reimbursement, and more. Learn more at https://careers.hcsc.com/totalrewards.

The offered salary will depend on skills, education, and experience. The role may include an annual incentive bonus, subject to plan terms.

HCSC Employment Statement

We are an Equal Opportunity Employer committed to a diverse and inclusive environment. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Base Pay Range: $60,300 - $133,400