<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> <p>Job Summary</p> <p>Responsible to contribute to the overall success of the Clinical Operations function by providing timely and accurate support to the Claims department to ensure the timely, independence and impartiality of all persons involved in making claim and appeal decisions.</p> <p>Required Job Qualifications:</p> <ul> <li>Current licensure RN in the state of residency and the state of employment and registrations, and/or any professional designations that may be required within the jurisdiction. License must be current and without standing or pending censure by any state. </li><li>2 years clinical experience </li><li>Minimum of 5 years of clinical consulting experience in a disability claims setting. </li><li>All clinical care managers must keep their clinical area of expertise current and acquire the necessary continuing education credits to keep his/her license, designation and/or certification current. </li><li>Assessments, problem solving, plan development and implementation skills. </li><li>Knowledge and understanding of CPT, ICD-9 and ICD-10 medical information within claim systems on cases referred. </li><li>Experience with LTD and/or STD with variety of impairment knowledge. </li><li>Analytical and decision-making skills. </li><li>Verbal and written communication and interpersonal skills </li><li>Knowledge of clinical terminology and practice processes. </li></ul> <p>Preferred Job Qualifications:</p> <ul> <li>Bachelors degree </li></ul> <p>THIS IS A REMOTE ROLE</p> <p>#LI-REMOTE</p> <p>#LI-CH1</p> <p>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!</p> <p>Pay Transparency Statement:</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 https://careers.hcsc.com/totalrewards.</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> <p>HCSC Employment Statement:</p> <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> <p>Base Pay Range</p> <p>$69,200.00 - $146,700.00</p>