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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.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>This position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance with contract guidelines. Prepares reports on quality of care, identifies and reports cases. Provides information regarding utilization management requirements and operational procedures to members, providers and facilities. Willingness and ability to travel.JOB REQUIREMENTS:  Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.  3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company.  Knowledge of medical terminology and procedures.  Verbal and written communication skills.  Willingness and ability to travel. PREFERRED JOB REQUIREMENTS:  Utilization management experience.  MCG Certification.Training Schedule: Mon-Fri (in office)Work Schedule (following training and production goals are met): Tue-Sat#LI-RemoteINBTAre 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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.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.<h2>HCSC Employment Statement:</h2>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.<h1>Base Pay Range</h1>$60,300.00 - $133,400.00

Blue Cross and Blue Shield of Oklahoma

Utilization Management Coord - New Mexico or Oklahoma

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.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>BASIC FUNCTION 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 ~Required Job Qualifications: <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>Preferred Job Qualifications: <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> NOTE: relocation will not be offered, sponsorship is not available ~ 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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.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.<h2>HCSC Employment Statement:</h2>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.<h1>Base Pay Range</h1>$69,200.00 - $146,700.00

Exec Protection Specialist

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.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>This position is responsible for assigned aspects of edical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas.JOB REQUIREMENTS:. * Physician (M.D. or D.O) with a current and unrestricted physician license in a the state of Oklahoma. * Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists * 5 years of clinical experience * Analytical and communication skills * Strategic thinking skills * Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews PREFERRED REQUIREMENTS: * 3 years Managed Care experienceThis is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.#LI-MG1Are 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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.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.<h2>HCSC Employment Statement:</h2>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.<h1>Base Pay Range</h1>$187,700.00 - $348,600.00

Medical Director

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.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>Under supervision, this position is responsible for working on the phone all day in a call center to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Duties include: conducting research; spends approximately 85% of the scheduled time on the phone according to business need.JOB REQUIREMENTS:<ul> <li>High school diploma OR GED.</li> <li>6 months customer service experience OR 6 months experience in an office environment.</li> <li>Data entry and/or typing experience.</li> <li>Interpersonal, verbal and written communication skills.</li> <li>Analytical and organizational skills and independent decision making skills.</li> <li>Ability to spend approximately 90% of the scheduled time on the phone according to business needs and sit for long periods of time with scheduled breaks.</li> </ul> ​PREFERRED JOB REQUIREMENTS:<ul> <li>9 months customer service experience.</li> <li>Experience working with various lines of business, i.e. CDHP, Medicare, Wellness, and Disease Management.</li> <li>Knowledge of medical terminology and anatomy.</li> <li>Proven ability to learn quickly and adapt to change.</li> <li>Referral preference given to applicants able to take and meet testing criteria.</li> </ul>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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.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.<h2>HCSC Employment Statement:</h2>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.<h1>Base Pay Range</h1>$17.75 - $27.83

Customer Advocate I

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.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>This position is responsible for designing enhancements and new business applications and/or information systems solutions through integration of technical and business requirements; serving as technical designer to identify best solution and resulting technical specifications within limits of code environment; linking Business Analyst needs and Architect definition to technical solutions. Ensure the integrity, security, scalability, and daily availability and of the databases supporting the Illinois and Texas Blue Chip and IRIS CICS applications through proactive monitoring and management activities.Required Job Qualifications * Bachelor Degree and 4 years Information Technology OR Technical Certification and/or College Courses and 6 year Information Technology experience OR 8 years Information Technology experience. * Knowledge of application configuration * Knowledge of Big Data Analytics - HAVeN / HADOOP/ Autonomy / Vertica. * Knowledge of Cloud computing / SaaS / IaaS / PaaS technologies. * Knowledge of Integration Technologies – Informatica/Mulesoft/Talend/Denodo. * Knowledge of Mobile technologies - iOS / Android / Java / HTML5. * Knowledge of Scripting Languages - BASH / PERL / PYTHON / RUBY. * Service Oriented Architecture - SOAP / REST. * Web Technologies - HTML/CSS/Java/ASP.Net/PHP/Ruby/C#. * Rapid prototyping. * Requirements definition &amp; management. * SDLC Methodology - Agile / Scrum / Iterative Development. * System Performance management. * Conceptual thinking. * Creative thinking. * Problem solving and analytical thinking. * Strong oral/written communication skills. Preferred Job Qualifications: * Bachelor Degree in Computer Science or Information Technology related. * Ability to execute. * Experience with Legal (Exterro, Axcelerate, Relativity), Audit (TeamMate Plus), Special Investigations (Healthcare Fraudshield) , Compliance (Verisys, Navex) and/or Privacy applications (Radar). * Support / Maintain database related applications.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 <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.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.<h2>HCSC Employment Statement:</h2>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.<h1>Base Pay Range</h1>$90,900.00 - $164,200.00

5 Blue Cross and Blue Shield of Oklahoma Jobs