Holistic Health Specialist (Employee Retirement Systems)

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

Job summary

Join a purpose-driven company that values employee growth and development. This remote role involves coordinating care, educating members, and overseeing health coordinators. You'll play a crucial role in managing treatment assignments and ensuring quality outcomes. If you're a dedicated Registered Nurse with a passion for patient care and experience in health management, this is an exciting opportunity to make a significant impact in the healthcare field while enjoying a comprehensive benefits package.

Benefits

Health and Wellness Benefits

401(k)

Pension

Paid Time Off

Parental Leave

Disability Insurance

Life Insurance

Employee Assistance Programs

Tuition Reimbursement

Paid Holidays

Qualifications

• Registered Nurse with 2+ years of clinical experience.
• Experience in care management within a health insurance setting.

Responsibilities

• Serve as a contact for members and healthcare personnel.
• Promote quality and cost-effective health outcomes.

Skills

Verbal Communication

Written Communication

Analytical Skills

Decision-Making Skills

Clinical Judgment

Education

Registered Nurse License

Advanced Degree or Certification

Tools

PC Applications (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 a single source of contact for members, healthcare personnel, and other entities involved in managing care. Responsibilities include identifying alternative treatment programs, consulting with physicians, providers, members, and resources to evaluate options and services needed to meet health needs, promoting quality and cost-effective outcomes, and serving as a liaison to physicians and members. Additional functions include determining treatment assignments, pre-admission/post-discharge counseling for acute conditions, establishing relationships with members, and providing post-discharge follow-up until short-term care needs are met. The role involves educating members, introducing them to website tools, and facilitating care coordination. Oversight of holistic health coordinators is also part of the responsibilities.

Job Requirements

• Registered Nurse (RN) with a current, valid, unrestricted license in the state of operation
• At least 2 years of clinical practice experience providing direct clinical care
• Minimum 1 year of experience in care 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 for staff oversight

Preferred Job Requirements

• Experience in case management
• Managing complex or catastrophic health cases
• Specialty clinical experience in areas like intensive care, orthopedics, NICU/pediatrics, oncology, diabetic management, or obstetrics
• Working toward or completed certifications like CCM, CCP, CDE, or MCG, or an advanced degree
• Knowledge of Milliman Guidelines or similar clinical guidelines
• Understanding of medical management policies and procedures

Additional Details

This is a remote role; candidates must reside within 250 miles of the office or within the posted state.

For referrals, ask your HCSC connection about our Employee Referral process.

Pay Transparency and Benefits

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 programs, paid holidays, tuition reimbursement, and more. Learn more at https://careers.hcsc.com/totalrewards.

Compensation varies based on skills, education, and experience, with an annual incentive bonus plan applicable.

Equal Opportunity Employment

HCSC is committed to diversity and inclusion. 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

$60,300.00 - $133,400.00