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.

Job Summary

This Position Is Responsible For Conducting Audits As Well As Monitoring Ongoing Quality Improvement Activities Within The Medical Management Program; Analyzing Compliance With Departmental Policies, Regulatory And Accrediting Requirements, And Preparing Reports For Management Presentation To Internal Ancillary Departments And Committees; And Serving As A Resource To Internal Ancillary Departments On Quality And Utilization Issues And Contributing To Accreditation Survey Processes.

Required Job Qualifications:
*Registered Nurse (RN), Licensed Practical Nurse (LPN), OR Behavioral Health Professional with unrestricted license to practice in state of operations
*3 years clinical experience, including 2 years utilization review or case management experience
*Quality improvement experience
*Working knowledge of the Medical Management Program and UM/CM policies and practices
*Analytical skills
*Verbal and written communication skills
*PC experience utilizing Microsoft Office software

Preferred Job Qualifications:
*Bachelor Degree in Nursing or Health Administration or in the healthcare field
*Certified Professional Health Care Quality (CPHQ Certification)

This role is 100% work from home based out of IL or TX

This role is Monday-Friday w/ standard business hours

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, 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.

Base Pay Range

$58,800.00 - $130,100.00