Holistic Health Specialist - ERS

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

Job summary

A leading health insurance provider in Texas seeks a Registered Nurse for a Telecommute role. The RN will handle care management, assess members, and educate them on wellness. Requires 2 years of clinical experience and familiarity with care management. Salary ranges from $60,300 to $133,400, with comprehensive benefits including life insurance and 401(k).

Benefits

Life insurance

Parental leave

Paid time off

401(k)

Qualifications

• 2 years of clinical practice experience with direct clinical care.
• 1 year of experience in care management in a health insurance setting.
• Specialty clinical experience in areas such as oncology or intensive care preferred.

Responsibilities

• Perform various functions as a contact for members and health care personnel.
• Identify treatment options and promote cost-effective outcomes.
• Educate members on wellness and coordinate care.

Skills

Clear and concise verbal and written communication skills

Analytical skills

Decision making skills and sound clinical judgment

PC proficiency including Word, Excel

Education

Registered Nurse (RN) license

Advanced degree or certification in health management

Job description

life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, 401(k)

United States, Texas, Houston

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

Job Summary

This Position Is Responsible For Performing A Variety Of Functions And Is A Single Source Of Contact For Members, Health Care Personnel And All Other Entities Involved In Managing Care. Identifies Alternate Treatment Programs; Consults With Physicians, Providers, Members, And Other Resources To Evaluate Options And Services Required To Meet An Individual's Health Needs. Promotes Quality And Cost Effective Outcomes; And Serves As Liaison To Physicians And Members.

Other Functions Also Include Determining Member Assignment Of Treatment, And Pre-Admission/Post-Discharge Counseling For An Acute Condition. Establish Relationship With The Member. Handle Immediate Post Discharge Follow-Up Or Until All Short Term Care Needs Are Met. Provide Education/Local Resource Information And Encourage Member (Self) Education.

Functioning In A Clinical Care Advisory Role, Assesses Members For Wellness Education And Disease Management, Introduces Members To Our Website Tools, Educates Members Regarding Wellness And Specific Conditions, And Facilitates The Coordination Of Care For Identified Members. Provide Oversight To Holistic Health Coordinators.

JOB REQUIREMENTS:

• Registered Nurse (RN) with current, valid, unrestricted license in state of operations
• 2 years of clinical practice experience of direct clinical care to the customer
• 1 year of experience in care management/condition management in a health insurance/managed care setting
• PC proficiency to include Word, Excel, Lotus Notes and database experience
• Clear and concise verbal and written communication skills
• Familiarity of ancillary services including HHC, SNF, Hospice, etc
• Analytical skills
• Decision making skills and sound clinical judgment to provide oversight of other staff

PREFERRED JOB REQUIREMENTS:

• Experience in managing complex or catastrophic health cases
• Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management)
• Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree
• Knowledge of Milliman Guidelines or similar clinical guidelines
• Knowledge of medical management policies and procedures

This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.

Benefits and Compensation

We offer a range of benefits, including life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, and 401(k). Our total rewards package also includes health and wellness benefits, pension plan, disability insurance, supplemental life insurance, employee assistance program, and more.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Base Pay Range $60,300.00 - $133,400.00

EEO Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.