Care Coordinator UM/CM I

Health Care Service Corporation • Tulsa, OK

5d • Remote

About The Position

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 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.

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.
• Multi-state license fees will be provided by HCSC.
• Incumbents with other clinical licenses are not required to obtain multi-state licenses.

Nice To Haves

• Familiarity with UM/CM activities and standardized criteria set.
• Knowledge of ancillary services including HHC, SNF, Hospice, etc.

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 individuals health needs within the scope of their benefit plan

Benefits

• 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.
• This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees