Unit Mgr Clinical Operations- HCSC
Company: Health Care Service Corporation
Posted on: April 27, 2019
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.
(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.
*Registered Nurse (RN), with current, unrestricted license to
practice in state of operations.
*2 years clinical experience with direct clinical care to the
*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
*Ability and willingness to travel, including overnight stays, as
PREFERRED JOB REQUIREMENTS:
*Experience with pediatric special needs population.
*Prior experience with Texas Medicaid Programs.
*2 years of management experience.
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,
Keywords: Health Care Service Corporation, Grapevine , Unit Mgr Clinical Operations- HCSC, Healthcare , Waco, Texas
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