Holistic Health Specialist - Work From Home

Job Summary This position is responsible for performing a variety of functions and serves as a single source of contact for members, health care personnel, and other entities involved in managing care. The role includes identifying alternate treatment programs, consulting with physicians, providers, and members to evaluate options, promoting quality and cost‑effective outcomes, and serving as liaison to physicians and members. Additional responsibilities include determining member assignment of treatment, providing pre‑admission/post‑discharge counseling, handling immediate post‑discharge follow‑up, providing education and local resource information, assessing members for wellness education and disease management, educating members on wellness tools, and coordinating care for identified members. The role also involves providing oversight to holistic health coordinators. Job Requirements Registered Nurse (RN) with current, valid, unrestricted license in state of operations 2 years of clinical practice experience providing direct clinical care to customers 1 year of experience in care management/condition management in a health insurance/managed care setting PC proficiency with 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 Preferred Job Requirements Active and unrestricted Compact Nursing license Case Management experience Experience managing complex or catastrophic health cases Specialty clinical experience in intensive care medicine, orthopedics, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management) Working toward or completion of CCM/CCP/CDE/MCG certification or an advanced degree Knowledge of Milliman Guidelines or similar clinical guidelines Knowledge of medical management policies and procedures Work hours in Central Standard Time Zone (9:30 AM to 6 PM CST Monday through Friday) and willingness to work in that time zone Work Arrangement This is a Remote/Work‑From‑Home role. Remote vacancies require an active and unrestricted Compact Nursing license. Work hours are in the Central Standard Time Zone (9:30 AM to 6 PM CST Monday through Friday) and the candidate must be willing to work in that time zone. Pay Transparency Statement At Health Care Service Corporation, we offer a robust total rewards package for employees including 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. Base Pay Range $61,500.00 - $136,100.00 HCSC Employment Statement We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at View phone number on click.appcast.io to request reasonable accommodations. #J-18808-Ljbffr