Blue Cross and Blue Shield of Illinois, Montana, N Unit Manager Clinical Operations in Richardson, Texas


HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can email us here to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".

BASIC FUNCTION:This position is responsible for supervising clinical staff involved in a variety of clinical operations such as Utilization Management, Case Management and/or Disease Management. Responsible for hiring, training, performance reviews, pay administration, change management and ensuring staff meet/exceeds goals and initiatives. Implement processes, procedures and initiatives and monitor results, ensure delivery of effective customer service, ensure department is meeting account contracts, and work across the organization in delivery of services to the customer.

JOB REQUIREMENTSRegistered Nurse (RN), with current, unrestricted license to practice in state of operations.2 years of clinical experience with direct clinical care to the consumer.2 years of utilization review/ managed care experience.Leadership skills.Knowledge of managed care program policies and procedures.Knowledge of managed care and insurance industry.Verbal, written, and interpersonal communication skills.PC proficiency to include Word, Excel, PowerPoint.Analytical skills and sound clinical judgment.Case Management Certification (URAC accredited certification) or obtain URAC accredited case management certification within 18 months of starting in the role if overseeing case management operations.* Willingness and ability to work until 6:30 pm Monday – Friday.*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:Utilization management experience.Supervisory experience.Bachelor degree.Six Sigma or LEAN certification.*Wellcoach, Health Coach or Motivational Interviewing certification.


Location: TX - Richardson

Activation Date: Tuesday, July 25, 2017

Expiration Date: Friday, September 1, 2017

Apply Here