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Displaying results 1 - 15 of 722

Utilization Management Coordinator (RN-Remote)

HCSC - Chicago, IL

***This will be a work from home position, candidates must reside within 100 miles of Chicago, IL*** BASIC FUNCTION: This position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Ne...

Sr Client Consultant

HCSC - Chicago, IL

BASIC FUNCTION: In this role, you will be responsible for creating medical plan review presentations for BCBS employer group clients and for presenting those reviews to the client. Creating the medical plan reviews and providing additional ad hoc analytics in support to your book of key accounts will require you to analyze health claims utilization and cost ...

Multimedia Developer II

HCSC - Richardson, TX

Job Purpose: This position is responsible for coordinating and producing internal- and external-facing presentation materials to support enterprise sales, marketing, communication, and training goals; consulting with clients, including company executives, and handling projects through revisions until final product approval is granted; and un...

Holistic Health Specialist - Registered Nurse (RN)

HCSC - Abilene, TX

** This position needs to be based a commutable distance within 100 miles from Richardson or Abilene, TX . ** BASIC FUNCTION: 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 ca...

Financial Research Technician

HCSC - Albuquerque, NM

BASIC FUNCTION: Under supervision, this position is responsible for researching refund checks, out of balance entries and non-negotiated checks. The research may result in action including offsetting, voiding or reissuing provider checks. The processes require knowledge of complex pricing, contract pricing and coordination of benefits. JOB REQUIREMENTS: * High scho...

Enterprise Network Consultant

HCSC - Oklahoma City, OK

BASIC FUNCTION: This position serves as an implementation and delivery lead supporting and leading complex projects or a program with a number of sub-projects that pertain directly to provider network implementation. The work can focus on the strategy and execution of existing and new network offerings (in group, government and retail...

Data Scientist

HCSC - Richardson, TX

As part of our Government Analytics & Modeling team, you will be able to help improve health outcomes for millions of members in our ACA, Medicare and Medicaid markets. By gathering and analyzing their health, social, and utilization data, you will build models to find the best way to close gaps in care thru our existing programs such as In-Home / Telehealth Visits, Annual Heal...

Case Management Coord II / FEP (Richardsn)

HCSC - Richardson, TX

** This position needs to be based a commutable distance within 100 miles from Richardson, TX. ** BASIC FUNCTION: This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs that provide medically necessary...

Customer Advocate I

HCSC - Rockford, IL

BASIC FUNCTION: Under supervision, this position is responsible for working on the phone all day in a call center to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Duties include: conducting research; spends approximately 90 of the scheduled time on the phone according to business need. JOB RE...

Business Analyst III

HCSC - Chicago, IL

"BASIC FUNCTION: This position is responsible for supporting business operations from a project perspective. Coordinates with business partners and IT teams in support of financial operations to gather business needs, success criteria for epics, and acceptance criteria for stories. Will also be involved in the investigation and resolution of production issues specific to...

Care Coordinator UM/CM (RN-Remote)

HCSC - Chicago, IL

***This will be a work from home role, candidates must reside within 100 miles of Chicago*** BASIC FUNCTION: 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 ...

Assoc IT Release Analyst

HCSC - Chicago, IL

Associate IT Release Analyst As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in...

Assoc IT Release Analyst

HCSC - Chicago, IL

Associate IT Release Analyst As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in...

Proposal Writer - RFI / RFP response writing

HCSC - United States of America

This position is responsible for writing and coordinating the activities associated with the Request for Proposal (RFPs) process ensuring the highest quality of service is provided while remaining consistent with the Company's policies, procedures and philosophies all under strict deadlines. Participate in the activities involved in the resolution of issues or concerns ass...

NA Account Manager I

HCSC - Houston, TX

Job Purpose: This position is responsible for supporting Sales or Account Management personnel in the prospecting, acquiring or renewing of business. Responsibilities can include conducting research on inquiries, resolving issues by working across divisions, communicating with brokers and clients, assisting in gathering information for proposals, maintaining databases, prep...