Full-Time

Care Coordinator UM/CM I

Posted on 1/11/2025

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 primarily through premiums paid by its members and focuses on delivering quality care. The company also invests in health and wellness programs aimed at reducing healthcare costs and improving 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 empower people to 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 local economic growth.
  • HCSC's investment in Solera Health supports digital health access and cost reduction initiatives.

What critics are saying

  • Increased competition from digital health platforms like Solera Health may lead to market cannibalization.
  • The acquisition of Cigna's Medicare businesses may expose HCSC to regulatory scrutiny and integration challenges.
  • Opening a new office in Houston may strain resources and divert focus from other initiatives.

What makes HCSC unique

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

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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

INACTIVE