Job Summary

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 with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan.

JOB REQUIREMENTS:
* Registered Nurse (RN) with current, valid, unrestricted license to practice in state of operations.
* 3 years clinical practice experience.
* Experience utilizing various software packages.
* Verbal and written communication skills.
* Analytical skills.
* 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. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.

PREFERRED JOB REQUIREMENTS:
* Familiarity with UM/CM activities and standardized criteria set.
* Familiarity with NFLOC (Nursing Facility Level of Care) for New Mexico Medicaid

* Familiarity with LTSS (Long Term Support Services) for New Mexico Medicaid

* Proficiency in MS Office Products: Word, Excel, PPT, Outlook, etc.

#LI-MC1 #INKT

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range
$61,500.00 - $136,100.00

Exact compensation may vary based on skills, experience, and location.