Registered Nurse

Posted on Nov 18, 2018 by Blue Cross and Blue Shield of Illinois, Montana, N

Dallas, TX 75219
Health Care
Immediate Start
Annual Salary

** This role will be supporting a dedicated client account and is located onsite at the C1 Innovation Lab in the West End in Downtown Dallas. **** The initial training for this position will be for approximately 4-weeks in Richardson, TX. **** THIS POSITION IS BASED ON-SITE AND IS NOT WORK FROM HOME (WFH) / TELECOMMUTE. **

------------------------------------------------------------C1 Innovation Lab (Downtown Dallas) -- Helping Customers Reimagine the Purpose of Health Insurance

Opened in August 2017 in the West End, the C1 Innovation Lab is a high-rise development housing HCSC in the Heart of Dallas. This is a place where we put our customers first while we imagine, explore, nurture and activate on their behalf. This facility serves as a beacon for customers to show them how committed we are to generating forward-thinking solutions that reduce health care expenses and improve health outcomes. It complements existing functions and infuses innovation into our daily operations.Learn more here and see how we're putting our Customers first:


At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" as one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.

Join us and grow your career as we do everything in our power to stand with our members in sickness and in health!


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 Network Management Divisions. This position reviews service requests, collects clinical and non-clinical data, verifies eligibility, determines benefit levels in accordance to contract guidelines, prepares reports on quality of care, identifies and reports cases, and provides information regarding utilization management requirements and operational procedures to members, providers and facilities. JOB REQUIREMENTS:*Registered Nurse (RN) with valid, current, unrestricted license in The State of Texas.*3 years of clinical experience as an RN in a physician's 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 (UM) experience.*MCG Certification.*Knowledge of Milliman Guidelines or similar clinical guidelines*Knowledge of medical management policies and procedures*BSN*Experience working with a dedicated unit or on a custom account/client management.*Prior experience working in an innovative, collaborative and open office environment

Location: TX - Dallas

Activation Date: Sunday, November 4, 2018

Expiration Date: Tuesday, January 1, 2019

Apply Here

Reference: 569503429

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