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Unit Mgr Clinical Operations- HCSC

Company: Health Care Service Corporation
Location: Waco
Posted on: April 27, 2019

Job Description:

Description:

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 partnerships in the communities where we work and live, because everyone should have access to quality health care. We use innovative tools and approaches to help members get the most out of their plan benefits, as affordably as possible. We are more than a health care insurer and we are truly anchored in our purpose: to do everything in our power to stand by our members in sickness and in health.

BASIC FUNCTION:

(TX STAR Kids)This position is responsible for supervising Texas STAR Kids Service Coordination Team clinical staff involved in a variety of clinical operations such as Service Coordination, Utilization Management, Case Management and/or Disease Management. Responsible for hiring, training, performance reviews, pay administration, change management and ensuring staff meet/exceeds goals and initiatives. Implement processes, procedures and initiatives and monitor results, ensure delivery of effective service coordination, customer service, ensure department is meeting State contracts, and work across the organization in delivery of services to the customer.

JOB REQUIREMENTS:
*Registered Nurse (RN), with current, unrestricted license to practice in state of operations.
*2 years clinical experience with direct clinical care to the consumer.
*2 years in Long Term Supports and Services and/or Service Coordination managed care experience.
*Leadership experience and skills.
*Knowledge of managed care program policies and procedures.
*Knowledge of managed care and insurance industry.
*Verbal, written, and interpersonal communication skills.
*PC proficiency to include Word, Excel, PowerPoint.
*Analytical skills and sound clinical judgment.
*Case Management Certification (URAC accredited certification) or obtain URAC accredited case management certification within three year of employment.
*Knowledge of State and Federal regulations related to Medicaid programs.
*Ability and willingness to travel, including overnight stays, as needed.

PREFERRED JOB REQUIREMENTS:

*Experience with pediatric special needs population.

*Prior experience with Texas Medicaid Programs.

*2 years of management experience.

*CA

Location: TX - Waco
Activation Date: Monday, April 8, 2019
Expiration Date: Wednesday, May 1, 2019

Associated topics: biopharmaceutical, dietetic, drug, histology, microbiology, nutritionist, physiologist, physiology, therapeutic, toxicologist

Keywords: Health Care Service Corporation, Grapevine , Unit Mgr Clinical Operations- HCSC, Healthcare , Waco, Texas

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