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Customer Advocate I
HCSC - Richardson, TX
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 REQUIREMENTS:...
Primary Nurse Case Admin I
HCSC - Richardson, TX
**This is a Work from Home position, in the Richardson, TX area** Basic Function: This position is responsible for performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities involved in managing care. The Pr...
On-Site Utilization Management Coordinator - Registered Nurse (RN) - Downtown Dallas
HCSC - Dallas, TX
** This role will be supporting a dedicated client account and is located onsite at the C1 Innovation Lab in the West End in Downtown Dallas. ** ** The initial training for this position will be for approximately 2-weeks in Richardson, TX. ** ** THIS POSITION IS BASED ON-SITE AND IS NOT WORK FROM HOME (WFH) / TELECOMMUTE. **
Behavioral Health Coordinator
HCSC - Chicago, IL
**THIS IS A UNION POSITION** BASIC FUNCTION: This position is responsible for responsible for providing support to members and physicians on case management or outpatient services including responding to inquiries, conducting outbound calls, scheduling appointments, conducting research, performing data entry, resolving problems by working across departments, and supporting the beha...
Health Coordinator
HCSC - Richardson, TX
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health by creating non-clinical ...
Network Management Consultant
HCSC - Richardson, TX
Located in Richardson or Houston this position is responsible for providing support to the provider recruitment and contracting process to ensure strategic coverage of providers for assigned territory. Specific responsibilities include small to mid-size contract negotiations for independent laboratories and developing and maintaining relationships with providers.This role will also provide s...
Claim Technician
HCSC - Marshall, TX
Job Purpose:Under supervision, this position is responsible for processing complex claims requiring further investigation, including coordination of benefits and resolving pended claims.Required Job Qualifications: * *High School diploma or GED. * *Data entry and/or typing experience. * *Clear and concise written and verbal communication skills. * *Experience process...
Internal Provider Network Representative II
HCSC - Austin, TX
JOB PURPOSE: This position is responsible for providing assistance to practitioners in resolution of claims, pricing, coding and contract issues; and working with internal departments to evaluate and resolve provider/contract and service issues. Handle more complex issues and may assist in training/mentoring staff. REQUIRED JOB QUALIFICATIONS: * Bachelor's degree and two years' ...
Senior Provider Engagement Strategy Consultant
HCSC - Chicago, IL
BASIC FUNCTION: This position is responsible for supporting the development of network strategies and provider engagement models that reflect innovative ways to buy care across lines of business and geographies; measuring provider efficiency in alternate reimbursement arrangements, providing end to end report development, interfacing between internal business and technical teams to achiev...
Senior Accreditation Coordinator
HCSC - Chicago, IL
JOB PURPOSE: Responsible for operations compliance with accreditation and regulatory requirements in assigned areas. Responsible for developing, coordinating, integrating and monitoring accreditation activities and initiatives in compliance to state and federal regulations. Responsibilities include collecting data and developing compliance documents/evidence for successful accreditation s...
RN Wellbeing Health Advisor
HCSC - Richardson, TX
**This position is based in the Richardson Headquarters office located in Richardson, TX, ** Job Purpose: This position will be responsible for focusing on the overall health of the member by assisting the member with the goal of increased health and overall wellbeing by developing a one-to-one relationship with the member. Encourage members to utilize appropri...
Provider Data Specialist
HCSC - Albuquerque, NM
At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" as one of our core values, we are focused on improving our success measures and delivering the best possible customer experience. Basic Fu...
Holistic Health Specialist - Registered Nurse (RN)
HCSC - Chicago, IL
** THIS POSITION IS BASED ON-SITE, IN-OFFICE IN CHICAGO, IL. APPLICANTS NEED TO LIVE A COMMUTABLE DISTANCE TO DOWNTOWN CHICAGO. ** 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 care. Identifies altern...
Marketing Service Representative - Healthcare Employee Benefits
HCSC - Richardson, TX
Located in Richardson TX within Sales & Account Management, this position is responsible for supporting Account Management personnel with a focus on renewal of existing business, servicing existing accounts. Additional duties may include support of prospecting and acquiring new business. JOB REQUIREMENTS: * 1 year experience in health care management in a marketing service represe...
Customer Advocate I
HCSC - Marion, 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 REQUIREMENTS:
