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    Medical nurse administrator - Chicago, IL, United States - HCSC

    HCSC
    HCSC Chicago, IL, United States

    4 days ago

    Default job background
    Description
    Primary Nurse Case Admin I- Boeing (IL RN license)

    At HCSC, we consider our employees the cornerstone of our business and the foundation to our success.

    We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

    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 Primary Nurse Coordinator performs concurrent review, discharge planning and care coordination; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual's health needs; promotes quality and cost effective outcomes; Establish relationship with the member through the immediate post discharge follow-up period or until all short term care needs are met.

    Provide education/local resource information and encourage member (self) education.

    Functioning in a clinical care advisory role, the Primary Nurse Coordinator assesses members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members.

    Registered Nurse (RN) with current, valid, unrestricted license in state of operations

    • 2 years clinical practice experience of direct clinical care to the customer
    • 1 year experience in Condition Management or Case Management in a health insurance, managed care, physician office or hospital setting.
    • PC proficiency to include Word, Excel, Lotus Notes and database experience
    • Knowledge of UM/CM/DM activities and standardized criteria set
    • Familiarity of ancillary services including HHC, SNF, Hospice, etc
    • 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. 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)
    • Knowledge of medical management policies and procedures
    This role is Monday - Friday with occasional scheduled weekend obligations
    100% remote

    HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.

    We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

    Drug screening and background investigation are required, as allowed by law.

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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