Holistic Health Specialist (Employee Retirement Systems)

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

Job summary

Join a purpose-driven company that empowers employees and invests in their professional growth. In this remote role, you will be the key contact for members and healthcare personnel, managing care and promoting quality outcomes. Your expertise as a Registered Nurse will be vital in assessing health needs, coordinating care, and providing education. With a commitment to employee well-being, this innovative firm offers competitive compensation and a supportive work environment. If you're ready to make a meaningful impact in healthcare, this opportunity is perfect for you!

Benefits

Health and wellness plans

401(k)

Pension

Paid time off

Parental leave

Disability insurance

Tuition reimbursement

Employee assistance programs

Paid holidays

Qualifications

• Must be a Registered Nurse with a valid license in the state of operations.
• 2+ years of clinical practice and 1+ year in care management required.

Responsibilities

• Act as a liaison for members and healthcare personnel, promoting quality outcomes.
• Assess members for wellness education and facilitate care coordination.

Skills

Registered Nurse (RN)

Clinical practice experience

Care management experience

PC applications proficiency

Verbal and written communication skills

Analytical skills

Decision-making skills

Education

Registered Nurse License

Advanced degree or certifications (CCM, CCP, etc.)

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 source of contact for members, healthcare personnel, and all other entities involved in managing care. Responsibilities include identifying alternative treatment programs, consulting with physicians, providers, members, and other resources to evaluate options and services required to meet individual health needs. The role promotes quality and cost-effective outcomes and acts as a liaison to physicians and members. Additional functions include determining member assignment of treatment, pre-admission/post-discharge counseling for acute conditions, establishing relationships with members, handling immediate post-discharge follow-up, providing education and local resource information, and encouraging member self-education. The position functions in a clinical care advisory role, assessing members for wellness education and disease management, introducing members to our website tools, educating them about wellness and specific conditions, and facilitating care coordination for identified members. Oversight of holistic health coordinators is also part of the role.

Job Requirements

• Registered Nurse (RN) with current, valid, unrestricted license in the state of operations
• At least 2 years of clinical practice experience providing direct clinical care
• 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
• Sound decision-making skills and clinical judgment to oversee staff effectively

Preferred Job Requirements

• Experience in case management
• Experience managing complex or catastrophic health cases
• Specialty clinical experience in areas such as intensive care medicine, orthopedics, NICU/pediatrics, oncology, diabetic management, or obstetrics (low to high risk maternity management)
• Working toward or holding certifications such as 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 telecommute (remote) role: Must reside within 250 miles of the office or anywhere within the posted state.

Referral Process: If you're being referred to this role, ask your connection at HCSC about our Employee Referral process.

Pay Transparency

At Health Care Service Corporation, we are committed to offering meaningful benefits to support our employees' lives outside of work. Our benefits include health and wellness plans, 401(k), pension, paid time off, parental leave, disability insurance, supplemental life insurance, employee assistance programs, paid holidays, tuition reimbursement, and other incentives. Learn more at https://careers.hcsc.com/totalrewards.

The offered compensation varies based on skills, education, knowledge, and experience. This role is eligible for an annual incentive bonus plan, subject to plan terms and conditions.

Equal Opportunity Employment

We are an Equal Opportunity Employer committed to a diverse and inclusive environment. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Base Pay Range

$60,300.00 - $133,400.00