Health Care Service Corporation
Care Coordinator UM/CM I - Work From Home
Company 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 Description
Requirements
Required Job Qualifications: Registered Nurse (RN) with current, valid, unrestricted license to practice in state of operations. 3 years clinical practice experience. Experience utilizing various software packages. Verbal and written communication skills. Analytical skills. Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses. Preferred Job Qualifications: Familiarity with UM/CM activities and standardized criteria set. Knowledge of ancillary services including HHC, SNF, Hospice, etc.
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Responsibilities
This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan.
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