Offer summary

Qualifications:

Bachelor's degree in Social Work or Psychology, or equivalent nursing qualifications (LVN, LPN, RN) with relevant experience., Knowledge of medical terminology and experience in managed care systems., Proficiency in Microsoft Office applications and strong customer service skills., Excellent verbal and written communication skills, including motivational interviewing techniques..

Key responsibilities:

Contact and educate members about health care programs and personal health plan needs.

Engage members in discussions about adherence to their health plans and respond to inquiries.

Support clinicians in the Medical Management department with provider and member activities.

Coordinate member medical needs and analyze their requirements for assistance.

Job description

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

Summary: This position is responsible for contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquires from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

JOB REQUIREMENTS:

Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.
Knowledge of medical terminology
Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs
PC proficiency including Microsoft Office applications
Customer service skills
Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues

PREFERRED REQUIREMENTS:

Case Management experience - HIGHLY PREFERRED
Professional verbal and written communication skills and professional phone experience - HIGHLY PREFERRED
LPN - HIGHLY PREFERRED
Nurses must be licensed in their state(s)
Payor insurance experience
Spanish bilingual a plus

Sponsorship will not be provided for this role.

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

Work Schedule: Standard 8 hours per day

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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

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.

HCSC Employment 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.