Full-Time

Behavioral Health Care Management Specialist

Posted on 11/20/2024

HCSC

HCSC

Health insurance provider in multiple states

Financial Services
Healthcare

Compensation Overview

$25.72 - $56.77Hourly

Junior, Mid

Remote in USA

Must reside within 250 miles of Albuquerque, NM or anywhere within New Mexico.

Category
Healthcare Administration & Support
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Required Skills
PowerPoint/Keynote/Slides
Requirements
  • Registered Nurse (RN), with 2 years direct clinical care to the consumer in a clinical setting or unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX, NM), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL, NM & TX) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor (LMHC, NM), with 2 years of clinical practice experience
  • Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
  • Experience handling medical management programs and health educations programs in an independent manner.
  • Knowledge of the health and wellness marketplace and employer trends.
  • Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
  • Analytical experience including medical data analysis.
  • PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
  • Plus 1 year's wellness or managed care experience presenting clinical issues with members/physicians.
  • 3 years clinical experience.
  • Patient education experience.
  • Condition Management experience.
  • Bilingual in English and Spanish.
  • Experience in managing complex or catastrophic cases.
  • Certification in Case Management, Training, Project Management or nationally recognized health care certification.
Responsibilities
  • Conducting care management and health education programs for customers on government health care programs.
  • Gathering, analyzing and providing data for regulatory reports.
  • Perform assessments, care planning, and other care reviews in the member/family home and telephonically.
  • Represent the company to members, providers, and state regulators.

HCSC provides health insurance services across five states: Illinois, Montana, New Mexico, Oklahoma, and Texas. The company offers a variety of health insurance plans designed for individuals, families, and businesses, ensuring that different healthcare needs are met. HCSC's plans work by collecting premiums from members, which fund the healthcare services they provide. In addition to insurance, HCSC invests in health and wellness programs aimed at lowering healthcare costs and enhancing the health outcomes of its members. What sets HCSC apart from other health insurance providers is its long-standing experience in the industry and its commitment to compassion and innovation in healthcare. The company's goal is to empower people to lead healthier lives while maintaining a focus on quality care.

Company Stage

N/A

Total Funding

$472.7M

Headquarters

Chicago, Illinois

Founded

N/A

Simplify Jobs

Simplify's Take

What believers are saying

  • The new Houston office will create numerous job opportunities, fostering local economic growth and community development.
  • The acquisition of Cigna's Medicare businesses will expand HCSC's product offerings and geographic reach, benefiting current and future members.
  • Recognition as one of the 'Best Places to Work in IT' and having a CEO listed among the 'Most Influential People in Healthcare' highlight HCSC's strong leadership and positive work environment.

What critics are saying

  • The $231,900 fine from the Illinois Department of Insurance for an inaccurate provider directory could damage HCSC's reputation and trust with members.
  • The integration of Cigna's Medicare businesses may pose operational challenges and potential disruptions.

What makes HCSC unique

  • HCSC's strategic expansion into local communities, such as the new Houston office, emphasizes its commitment to economic growth and local workforce development, setting it apart from competitors.
  • The acquisition of Cigna's Medicare businesses significantly enhances HCSC's capabilities and reach in the growing Medicare market, providing a competitive edge.
  • HCSC's collaboration with Feeding America to address root causes of hunger showcases its holistic approach to community health, beyond traditional healthcare services.

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