Full-Time

Care Coordinator UM/CM I

Confirmed live in the last 24 hours

HCSC

HCSC

Health insurance provider in multiple states

Financial Services
Healthcare

Compensation Overview

$60.3k - $133.4kAnnually

+ Annual Incentive Bonus

Mid

No H1B Sponsorship

Remote in USA

Must reside within a 250-mile radius of Albuquerque, NM.

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary

You match the following HCSC's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • 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.
Responsibilities
  • 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 individual's health needs within the scope of their benefit plan.
Desired Qualifications
  • Familiarity with UM/CM activities and standardized criteria set.
  • Knowledge of ancillary services including HHC, SNF, Hospice, etc.

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 generates revenue through premiums paid by its members and focuses on delivering quality care while also investing in health and wellness programs. These programs aim to lower overall healthcare costs and enhance the health outcomes of its members. With nearly 100 years of experience in the industry, HCSC distinguishes itself from competitors by its commitment to compassion and a focus on innovative solutions that help people lead healthier lives.

Company Stage

N/A

Total Funding

$511.7M

Headquarters

Chicago, Illinois

Founded

1936

Simplify Jobs

Simplify's Take

What believers are saying

  • HCSC's acquisition of Cigna's Medicare businesses expands its reach in the growing Medicare market.
  • The new Houston office will create job opportunities and drive economic growth in Texas.
  • HCSC's investment in Solera Health enhances digital health access and integration.

What critics are saying

  • Increased competition from digital health platforms could shift market dynamics and expectations.
  • The acquisition of Cigna's Medicare businesses may lead to regulatory scrutiny and integration challenges.
  • Opening a new office in Houston could result in increased operational costs and workforce management issues.

What makes HCSC unique

  • HCSC's nearly century-long experience establishes it as a trusted health insurance provider.
  • The company invests in wellness programs to reduce costs and improve member outcomes.
  • HCSC's community-first engagement model values local relationships and personalized care.

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Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Paid Holidays

Paid Parental Leave

Disability Insurance

Supplemental Life Insurance

Employee Assistance Program

Tuition Reimbursement

Professional Development Budget