Empowering Whole Person Health With Compassion and Innovation
Holistic Health Specialist
Location
CST (UTC-6)
Posted
4 days ago
Salary
$61.5K - $136.1K / year
Seniority
Mid Level
Job Description
Holistic Health Specialist
Health Care Service Corporation
Role Description This position is responsible for performing a variety of functions and is a single source of contact for members, health care personnel, and all other entities involved in managing care. Responsibilities include: - Identifying alternate treatment programs. - Consulting with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs. - Promoting quality and cost-effective outcomes. - Serving as a liaison to physicians and members. - Determining member assignment of treatment. - Providing pre-admission/post-discharge counseling for an acute condition. - Establishing relationships with members. - Handling immediate post-discharge follow-up until all short-term care needs are met. - Providing education/local resource information and encouraging member (self) education. - Functioning in a clinical care advisory role, assessing members for wellness education and disease management. - Introducing members to website tools and educating them regarding wellness and specific conditions. - Facilitating the coordination of care for identified members. - Providing oversight to holistic health coordinators. Qualifications - Registered Nurse (RN) with current, valid, unrestricted license in state of operations. - 2 years of clinical practice experience of direct clinical care to the customer. - 1 year of experience in care management/condition management in a health insurance/managed care setting. - PC proficiency to include Word, Excel, Lotus Notes, and database experience. - Clear and concise verbal and written communication skills. - Familiarity with ancillary services including HHC, SNF, Hospice, etc. - Analytical skills. - Decision-making skills and sound clinical judgment to provide oversight of other staff. Requirements - Must have an active and unrestricted Compact Nursing license. - Case Management experience is needed. - Experience in managing complex or catastrophic health cases. - Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management). - Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree. - Knowledge of Milliman Guidelines or similar clinical guidelines. - Knowledge of medical management policies and procedures. - Work Hours are in the Central Standard Time Zone (9:30 AM to 6 PM CST Monday through Friday) and must be willing to work in that Time Zone (CST). Benefits - 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. - Other incentives. Company Description 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.
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