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Health Coordinator
HCSC - Chicago, IL
**This is a union role out of our Chicago office** **It is a Telecommuter/Remote/WFH position** BASIC FUNCTION: This position is responsible for contacting members to inform and educate them on our medical management programs; conducting research, performing data entry, responding to inquires from members, and supporting the clinicians in the Me...
Clinical Pharmacist
HCSC - Chicago, IL
***POSITION IS FOR THE CHICAGO OFFICE, WITH A HYBRID/FLEX WORK SCHEDULE*** Specialty Drug and Pharmacy Network experience is preferred. BASIC FUNCTION: This position is responsible for performing activities associated with administration and management of pharmacy programs including but n...
Assoc Life & Waiver Examiner - Lombard/ Richardson
HCSC - United States of America
(Dearborn National) BASIC FUNCTION: Under supervision, this position is responsible for reviewing and processing of life, waiver of premium, AD & D, Critical Illness, and Accident Insurance claims for Group Insurance policies. Manage assigned workload effectively with coaching on complex situations by Supervisor or Manager. Performs ...
Wellbeing Health Advisor (RN-Remote)
HCSC - Chicago, IL
***This will be a work from home position, candidates must reside within 100 miles of Chicago*** Job Purpose: This position will be responsible for focusing on the overall health of the member by assisting the member with the goal of increased health and overall wellbeing by developing a one-to-one relationship with the member. Encourage members to utilize appropr...
Utilization Management Coordinator (RN-Remote)
HCSC - Chicago, IL
***This will be a work from home position, candidates must reside within 100 miles of Chicago*** BASIC FUNCTION: 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 Networ...
Sr BA
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...
Quality Control Specialist
HCSC - Richardson, TX
BASIC FUNCTION: Under supervision, this position is responsible for ensuring the accuracy of auditing and data entry within the department; documenting quality performance audits, maintaining quality assurance statistics; and providing training as needed. JOB REQUIREMENTS: High school diploma or GED. 2 years busi...
Primary Nurse Case Administrator (RN-Remote)
HCSC - Chicago, IL
***This will be a work from home position, candidate must resdie within 100 miles of Chicago*** Basic Function: This position is responsible for performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities involved in managing ca...
Primary Nurse Case Administrator I
HCSC - Downers Grove, IL
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...
Pharmacy Operations Representative
HCSC - Albuquerque, NM
**REMOTE POSITION - REPORTING OFFICE IS THE ALBUQUERQUE HQ OFFICE)** Must be a Licensed/Certified Pharmacy Technician. BASIC FUNCTION: This position is responsible for providing assistance to pharmacists and pharmacy coordinators in resolution of claims, pricing, coding. Works with internal departments a...
Customer Advocate I
HCSC - Belleville, IL
BASIC FUNCTION: This position is located in Belleville, IL. Under supervision, this position is responsible for working on the phone in a call center to assist members Providers Groups and third parties by responding to telephone inquiries in a prompt, accurate and objective manner. Duties include conducting research and adjudication of Processor level claims while spending ...
Correspondent Advocate
HCSC - Mattoon, IL
*This position allows for potential flex/telecommute schedule after 9 months based on performance.** BASIC FUNCTION: Under supervision, this position is responsible for conducting research and providing responses to a variety of written and web based inquiries from beneficiaries, providers, blues plans and etc. ...
Customer Advocate I
HCSC - Amarillo, TX
BASIC FUNCTION: This position is located in Amarillo, TX. Under supervision, this position is responsible for working on the phone in a call center to assist members Providers Groups and third parties by responding to telephone inquiries in a prompt, accurate and objective manner. Duties include conducting research and adjudication of Processor level claims while spending up...
Claims Processor
HCSC - Marion, IL
Job Purpose: Under supervision this position is responsible for processing claims requiring investigation, phone calls, accessing resource materials and several support files; screening and editing claims data for accuracy; and processing for adjudication. Required Job Qualifications: * *High School diploma or GE...
Care Coordinator UM/CM (RN-Remote)
HCSC - Chicago, IL
***This will be a work from home role, candidates must reside within 100 miles of Chicago*** BASIC FUNCTION: 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 ...
