Holistic Health Specialist

2 weeks ago

Dallas, Texas, United States Health Care Service Corporation Full time
Job Summary

C1 Innovation Lab (Dallas) is a cutting-edge facility that puts our members first, imagining, exploring, nurturing, and activating on their behalf.

This role is responsible for performing a variety of functions and is a single source of contact for members, healthcare personnel, and other entities involved in managing care.

Identifies alternate treatment programs; 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; and serves as liaison to physicians and members.

Other functions include determining member assignment of treatment, and pre-admission/post-discharge counseling for an acute condition.

Establishes relationships with members, handles immediate post-discharge follow-up, and provides education/local resource information and encourages member (self) education.

Functioning in a clinical care advisory role, 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.

Provides oversight to holistic health coordinators.

Requirements
  • Registered Nurse (RN) with current, valid, unrestricted license in state of operations
  • 2 years of clinical practice experience of direct clinical care to the customer
  • 1 year of experience in care management/condition management in a health insurance/managed care setting
  • PC proficiency to include Word, Excel, Lotus Notes, and database experience
  • Clear and concise verbal and written communication skills
  • Familiarity of ancillary services including HHC, SNF, Hospice, etc
  • Analytical skills
  • Decision-making skills and sound clinical judgment to provide oversight of other staff
Preferred Requirements
  • 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)
  • Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree
  • Knowledge of Milliman Guidelines or similar clinical guidelines
  • Knowledge of medical management policies and procedures

This is a hybrid role in downtown Dallas in the West-End.

You must live in or near Dallas, TX for this role.

Work schedule is Tues, Weds, and Thurs in office and Mon & Friday remote.

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position.

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued.

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

Base Pay Range: $58,130.00

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