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Clinical Account Consultant - Work from Home

Role overview

Summary

This role is for managing accounts from a medical management perspective at HCSC. You will act as the primary contact for major accounts, facilitating communication between marketing and health care management while analyzing data to enhance program operations.

Qualifications

  • Registered Nurse (RN) or Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC) or Registered Dietitian (RD) with current, unrestricted, valid license.
  • 4 years’ experience in a position requiring understanding/applications of managed care products.
  • 3 years clinical or behavioral counseling experience.
  • Project management experience including development, implementation and follow-up.
  • Knowledge of URAC, NCQA, State Department of Insurance and/or standards and accreditation processes.

Responsibilities

  • Perform account management functions from the medical management perspective.
  • Serve as the primary contact for marketing major/national and mid-market accounts regarding medical issues and questions.
  • Analyze data and interpret information in preparation for meetings, site visits, and requests for proposals.
  • Recommend program enhancements to health care management operations based on client feedback.

Key facts

Hard skills

Other skills

  • Organizational Skills
  • Microsoft PowerPoint
  • Business Acumen
  • Communication

About the company

Health Care Service Corporation logo

Health Care Service Corporation

  • Health Insurance & Payers
  • XLarge
  • 10,001+
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.

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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

This position is responsible for performing account management functions from the medical management perspective; serving as primary contact for marketing major/national and mid-market accounts specific to presentations for existing and prospective clients, medical issues and questions on medical management programs; serving as liaison between marketing and health care management to analyze data and interpret information in preparation for meetings, site visits, and requests for proposals; and recommending program enhancements to health care management operations based on client feedback. Ability to travel, including overnight stays.

JOB REQUIREMENTS:

  • Registered Nurse (RN) or Licensed Master Social worker (LMSW),Licensed Professional Counselor (LPC) or Registered Dietitian (RD) with current, unrestricted, valid license in the state of operations.
  • 4 years’ experience in a position which requires understanding/applications of managed care products, e.g. PPO, HMO, and CDHP.
  • 3 years clinical or behavioral counseling experience.
  • Project management experience including development, implementation and follow-up.
  • Knowledge of URAC, NCQA, State Department of Insurance and/or standards and accreditation processes of comparable regulatory bodies, i.e. JCAHO.
  • Organizational skills for maintaining a library of presentations.
  • Verbal and written communication skills for crafting presentation including developing corporate communications/ presentations.
  • Business writing skills with ability to build customer relations.
  • Ability to interact with numerous internal departments and keep abreast of products and service deliverables.
  • PC proficiency to include Microsoft Applications with emphasis on developing PowerPoint presentations and other presentation formats.
  • Ability to travel, including overnight stays.

PREFERRED JOB REQUIREMENTS:

  • Knowledge of HCSC internal product implementation processes and national account delivery model.
  • Client-facing experience.
  • Knowledge of Business Acumen.
  • Experience in role as strategic clinical consultant or clinical account executive.
  • Strategic project management experience including development, implementation, evaluation and follow-up.
  • Knowledge of the Health and Wellness Marketplace and Programming.
  • Strong organizational skills and the ability to interact with numerous internal departments and keep abreast of products and service deliverables.
  • Prior experience participating in and supporting RFPs for clients.
  • 3+ years’ experience as a Strategic Clinical Account Consultant/Executive in the Health and Wellness industry.
  • 3+ years’ experience working with large, complex national clients.
  • 3+ years' experience analyzing and presenting clinical information and program performance data and recommended course corrections.
  • Experience presenting and working with major consulting firms.

This is a Telecommute (Remote) role.


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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range

$84,400.00 - $152,300.00

Exact compensation may vary based on skills, experience, and location.

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