Holistic Health Specialist (Health Advocacy Solutions)

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

Job summary

Join a purpose-driven company that prioritizes professional development and fosters rewarding careers. In this remote role, you'll be responsible for managing care and serving as a liaison between members and healthcare providers. Your expertise will help identify treatment options, promote quality outcomes, and support members through their healthcare journeys. This position offers a competitive salary and the opportunity to make a significant impact in the lives of others. If you're passionate about healthcare and looking for a fulfilling career, this is the perfect opportunity for you.

Qualifications

• Must be a Registered Nurse with a valid license.
• 2 years of clinical practice experience required.

Responsibilities

• Act as a liaison for members and healthcare personnel.
• Assess members for wellness and disease management.

Skills

Clinical Practice Experience

Care Management

Communication Skills

Analytical Skills

Decision-Making Skills

Proficiency in PC Applications

Education

Registered Nurse (RN) License

CCM Certification

Tools

Word

Excel

Lotus Notes

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.

This position is responsible for performing various functions and acts as the 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 to meet health needs, promoting quality and cost-effective outcomes, and serving as a liaison to physicians and members. Additional duties include determining member treatment assignments, pre-admission and 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 role also involves assessing members for wellness and disease management, introducing members to our website tools, educating them about wellness and specific conditions, and coordinating care for identified members. 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 care to patients

• 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 for overseeing staff

PREFERRED JOB REQUIREMENTS:

• RN Compact License

• Case Management experience

• CCM Certification (a plus)

• Experience managing complex or catastrophic health cases

• Specialty clinical experience in areas such as intensive care, orthopedics, NICU/pediatrics, oncology, diabetes management, or obstetrics (low to high risk maternity)

• Progress toward or completion of CCM/CCP/CDE/MCG certification or an advanced degree

• Knowledge of Milliman Guidelines or similar clinical guidelines

• Knowledge of medical management policies and procedures

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

Compensation ranges from $60,300 to $133,400, depending on skills, experience, and location.

HCSC Employment Statement:

We are an Equal Opportunity Employer committed to a diverse and inclusive workplace. 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.

Learn more about our benefits at https://careers.hcsc.com/totalrewards.