Holistic Health Specialist (Health Advocacy Solutions)

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

Job summary

An established industry player is seeking a dedicated Registered Nurse to join their remote team. This role focuses on managing care for members, providing clinical support, and ensuring quality outcomes through effective communication and coordination. With a commitment to professional development and a supportive work environment, this opportunity allows you to make a significant impact on the health and wellness of individuals. If you are passionate about patient care and looking to grow your career in a purpose-driven organization, this position is perfect for you.

Qualifications

• 2+ years of clinical practice providing direct clinical care.
• Experience in care management within a health insurance setting.

Responsibilities

• Serve as the primary contact for members and healthcare personnel.
• Coordinate care and provide education for wellness and disease management.

Skills

Clinical Care

Communication Skills

Analytical Skills

Decision-Making Skills

PC Applications Proficiency

Education

Registered Nurse (RN) License

CCM Certification

Tools

Microsoft Word

Microsoft Excel

Lotus Notes

Job description

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 a variety of functions and serves as the primary 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, and promoting quality and cost-effective outcomes. The role also involves serving as a liaison to physicians and members, determining member treatment assignments, providing 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. Additionally, the role includes providing education and local resource information, encouraging member self-education, assessing members for wellness and disease management, introducing website tools, and coordinating care. 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 operation
• 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
• Decision-making skills and sound clinical judgment to oversee 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, diabetic management, or maternity care
• 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

Additional Information

This is a remote (telecommute) role: candidates 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 is 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, protected veteran status, or other legally protected characteristics.

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