field_remote_option

job_industry

field_job_occupational_field_parents_all

job_organization_name

job_upgrade_is_featured

<p>At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.</p><p>Join HCSC and be part of a purpose-driven company that will invest in your professional development.</p><h1><b>Job Summary</b></h1>This position is responsible for performing a variety of functions and is a single source of contact for members, health care personnel and all 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 also include determining member assignment of treatment, and pre-admission/post-discharge counseling for an acute condition. Establish relationship with the member. Handle immediate post discharge follow-up 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, 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. Provide oversight to holistic health coordinators.<h2><b>JOB REQUIREMENTS:</b></h2><ul> <li><h2>Registered Nurse (RN) with current, valid, unrestricted license in state of operations</h2></li> <li><h2>2 years of clinical practice experience of direct clinical care to the customer</h2></li> <li><h2>1 year of experience in care management/condition management in a health insurance/managed care setting</h2></li> <li><h2>PC proficiency to include Word, Excel, Lotus Notes and database experience</h2></li> <li><h2>Clear and concise verbal and written communication skills</h2></li> <li><h2>Familiarity of ancillary services including HHC, SNF, Hospice, etc</h2></li> <li><h2>Analytical skills</h2></li> <li><h2>Decision making skills and sound clinical judgment to provide oversight of other staff</h2></li> </ul><h2> <br><br><b>PREFERRED JOB REQUIREMENTS:</b> </h2><ul> <li><h2>RN Compact License required</h2></li> <li><h2>Case Management experience</h2></li> <li><h2>CCM Certification a plus</h2></li> <li><h2>Experience in managing complex or catastrophic health cases</h2></li> <li><h2>Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management)</h2></li> <li><h2>Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree</h2></li> <li><h2>Knowledge of Milliman Guidelines or similar clinical guidelines</h2></li> <li><h2>Knowledge of medical management policies and procedures</h2></li> </ul><h2> <b>This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state. </b><br> </h2><p><b>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</b></p><p><b>Pay Transparency Statement:</b></p><p>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.</p><p>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.</p><h2>HCSC Employment Statement:</h2><p>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.</p><h1><b>Base Pay Range</b></h1>$60,300.00 - $133,400.00

Health Care Service Corporation

Holistic Health Specialist (Health Advocacy Solutions)

<p>At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.</p><p>Join HCSC and be part of a purpose-driven company that will invest in your professional development.</p><h1><b>Job Summary</b></h1>HCSC is looking for dynamic individuals to join its Executive Protection department! This position is responsible for the day-to-day operational protection and security logistics of key HCSC Senior Executives in various geographical areas. Additional protective activities may also extend to the HCSC Board of Directors, Senior Leadership Team, any persons designated by the CEO, or to other corporate business units and occasional domestic travel may be required. Duties will include but are not limited to physical protection, threat assessment and intelligence gathering, executive logistics and transportation, liaison with law enforcement officials, and maintaining regular contact with management. Incumbent will secure high-profile corporate individuals from potential threats and manage risks, assess danger levels, and plan secure routes for travel. NOTE: relocation will not be offered, sponsorship is not available ~<p><b>Required Job Qualifications: </b></p><ul> <li>Bachelor’s degree and 5 years of experience in law enforcement or the security and safety profession OR 9 years of experience in law enforcement or the security and safety profession.</li> <li>Excellent communication and interpersonal skills. Ability to deal with individuals at all levels within a large organization.</li> <li>Ability to deal effectively with law enforcement at all levels.</li> <li>Ability to analyze and prioritize tasks.</li> <li>Ability to work with high level corporate executives and their support teams.</li> <li>Ability to travel based on requirements of assigned executives.  </li> <li>A valid driver's license and clean driving record.</li> <li>Authorization to carry and use firearms. Currently hold a HR 218/ Law Enforcement Officer’s Safety Act certification.</li> <li>Strong physical fitness and the ability to meet physical demands of the role.</li> <li>Proficiency in threat assessment and risk management.</li> <li>Keen attention to detail and exceptional situational awareness.</li> <li>Strong discretion and the ability to handle sensitive information.</li> </ul><p><b>Preferred Job Qualifications: </b></p><ul> <li>Certified Protection Professional (CPP), Physical Security Professional (PSP), as certified by the American Society for Industrial Security (ASIS).</li> <li>CPR, AED, and first aid certification.</li> <li>Bachelor’s degree in criminal justice.</li> </ul><p> NOTE: relocation will not be offered, sponsorship is not available ~<br> </p><p><b>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</b></p><p><b>Pay Transparency Statement:</b></p><p>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.</p><p>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.</p><h2>HCSC Employment Statement:</h2><p>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.</p><h1><b>Base Pay Range</b></h1>$69,200.00 - $146,700.00

Exec Protection Specialist

Blue Cross and Blue Shield of Oklahoma

<p>At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.</p><p>Join HCSC and be part of a purpose-driven company that will invest in your professional development.</p><h1><b>Job Summary</b></h1>This is an opportunity for a motivated lawyer to provide counsel relating to complex matters relating to insurance regulatory filings, financial reporting, treasury support, corporate governance, subsidiary operations and transactions. This position provides guidance and support on insurance regulatory filings and requests and represents HCSC in dealing with trade organizations and regulators. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC’s established business and to further its growth while continually advancing HCSC’s mission.<br><br>HCSC is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. In addition to its core health insurance offerings, HCSC is proud to serve millions of people through a diverse portfolio of businesses that provide adjacent products and services. These companies help advance HCSC’s goal of expanding access to quality, cost-effective health care to help people live healthier.<br><br>The position can be based in Chicago, Illinois; Richardson, Texas; Tulsa, Oklahoma; Albuquerque, New Mexico; Helena, Montana, or Nashville, Tennessee.<br><br>Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location.<br><br>Sponsorship is not available for this position.<p><b>JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Juris Doctor Degree and a license to practice law in the state where the legal department is located.</p></li> <li><p>5 years experience as a practicing attorney after receiving a law degree.</p></li> <li><p>Demonstrated experience with insurance and healthcare regulations.</p></li> <li><p>Clear and concise verbal and written communication skills.</p></li> </ul><p><b>PREFERRED JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Knowledge or understanding of the health care, health insurance, or claim administration field.</p></li> <li><p>3+ years’ experience advising providers, insurers, or other health care entities.</p></li> </ul><p>#LI-AZ1</p><p>#LI-HYBRID</p><p><b>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</b></p><p><b>Pay Transparency Statement:</b></p><p>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.</p><p>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.</p><h2>HCSC Employment Statement:</h2><p>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.</p><h1><b>Base Pay Range</b></h1>$118,800.00 - $220,800.00

Assistant General Counsel - Corporate Regulatory

<p>At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.</p><p>Join HCSC and be part of a purpose-driven company that will invest in your professional development.</p><h1><b>Job Summary</b></h1>This is an opportunity for a motivated lawyer to provide legal support to HCSC’s health care management and clinical strategy and operations teams and other internal business partners supporting HCSC clinical initiatives across all lines of business. HCSC is the largest customer-owned health insurer in the United States, operating through its Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. <br>In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC’s established business and to further its growth while continually advancing HCSC’s mission of expanding access to high-quality, cost-effective health care.<br><br>The position can be based in Chicago, Illinois; Richardson, Texas; Tulsa, Oklahoma; Albuquerque, New Mexico; Helena, Montana, or Nashville, Tennessee<br><br>Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location.<br><br>Sponsorship is not available for this position.<p><b>JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Juris Doctor Degree and a license to practice law in the state where the legal department is located.</p></li> <li><p>5 years experience as a practicing attorney after receiving a law degree.</p></li> <li><p>Clear and concise verbal and written communication skills</p></li> </ul><p><b>PREFERRED JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Knowledge or understanding of the health care, health insurance, or claim administration field.</p></li> <li><p>3+ years’ experience advising insurers, third-party administrators, or health plans on health plan administration, laws and regulations relating to commercial health plans (self-funded and fully insured), Medicare Advantage and Medicaid managed care plans, Affordable Care Act plans, HIPAA and relevant healthcare privacy laws, and other relevant federal and state healthcare laws.</p></li> <li> <p>Knowledge and understanding regarding:</p> <ul> <li><p>federal and state fraud and abuse laws relating to health care and health plans, including but not limited to federal and state false claims acts, the federal Anti-Kickback Statute, Civil Monetary Penalties Law, and other similar laws.</p></li> <li><p>federal and state laws that relate to health plan quality and performance improvement issues such as payment integrity, billing, and coding accuracy services, population health services, utilization management, prior authorization, and other quality and performance improvement initiatives.</p></li> </ul> </li> <li><p>Strong business collaboration and writing skills, including the ability to clearly provide legal counsel and solutions to complex issues.</p></li> </ul><p>#LI-AZ1</p><p>#LI-HYBRID</p><p><b>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</b></p><p><b>Pay Transparency Statement:</b></p><p>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.</p><p>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.</p><h2>HCSC Employment Statement:</h2><p>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.</p><h1><b>Base Pay Range</b></h1>$118,800.00 - $220,800.00

Assistant General Counsel - Clinical

<p>At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.</p><p>Join HCSC and be part of a purpose-driven company that will invest in your professional development.</p><h1><b>Job Summary</b></h1>This is an opportunity for a motivated lawyer to provide counsel relating to complex contracting, including vendor, provider network, producer/customer, and strategic sourcing contracting. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC’s established business and to further its growth while continually advancing HCSC’s mission.<br><br>HCSC is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. In addition to its core health insurance offerings, HCSC is proud to serve millions of people through a diverse portfolio of businesses that provide adjacent products and services. These companies help advance HCSC’s goal of expanding access to quality, cost-effective health care to help people live healthier.<br><br>The position can be based in Chicago, Illinois; Richardson, Texas; Tulsa, Oklahoma; Albuquerque, New Mexico; Helena, Montana, or Nashville, Tennessee.<br>Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location.<br><br>Sponsorship is not available for this position.<p><b>JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Juris Doctor Degree and a license to practice law in the state where the legal department is located.</p></li> <li><p>5 years’ experience as a practicing attorney after receiving a law degree.</p></li> <li><p>Clear and concise verbal and written communication skills.</p></li> </ul><p><b>PREFERRED JOB REQUIREMENTS</b><b>:</b></p><ul> <li><p>Knowledge or understanding of the health care, health insurance, or claim administration field.</p></li> <li><p>3+ years’ experience advising providers, insurers, or other health care entities.</p></li> </ul><p>#LI-AZ1</p><p>#LI-HYBRID</p><p><b>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</b></p><p><b>Pay Transparency Statement:</b></p><p>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.</p><p>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.</p><h2>HCSC Employment Statement:</h2><p>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.</p><h1><b>Base Pay Range</b></h1>$118,800.00 - $220,800.00

6 Other Jobs in Albuquerque, NM, USA