Clinical Advisor - LH

Health Care Service Corporation

Job Overview

Location

Work From Home (HB)

Job Type

Full-time

Full Job Description

📋 Description

• The Clinical Advisor provides day-to-day client support on behalf of the Health Care Management department, ensuring client needs are met through strategic collaboration with Healthcare Management and non-Healthcare Management teams.
• Day-to-day responsibilities include supporting members and clients, collaborating on Utilization Review and Case Management workflows, maintaining active communication with internal and external stakeholders (sales, clinical teams, client management, claims, managed care), and delivering solutions to drive business growth.
• The role involves an active visible presence with clients for management and support, working under the Senior Director, Clinical Consultant to align processes with client needs and organizational goals.
• The Clinical Advisor will develop expertise in healthcare consulting, client relationship management, and healthcare operations while contributing to process improvements and strategic initiatives within a purpose-driven organization invested in employee development.

🎯 Requirements

• Associate Degree and Active State Registered Nursing License
• Minimum five years’ experience in direct clinical care and/or minimum of three years’ experience in medical management including case management or utilization management
• Minimum 1 year in healthcare consulting (client facing role or experience in delivery of results to clients)
• Knowledge of Health Care, Industry and Managed Care Delivery systems including medical practice standards, insurance benefit structure, legal/medical issues, utilization management, case management, and quality management processes
• Ability to actively manage and deliver on client expectations around projects, timelines, deliverables, and outcomes
• Excellent oral, written, and presentation communication skills with ability to interact effectively with clients and internal stakeholders
• Strong organizational skills with attention to detail and ability to prioritize efforts under tight deadlines and multiple complex projects
• Demonstrated ability to adapt, quickly learn new skills, and serve as a sponsor of change
• Ability to travel as needed and demonstrated knowledge of Microsoft Office Suite products

🏖️ Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off and paid parental leave
• Disability insurance and supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Annual incentive bonus plan (subject to plan terms and conditions)

Skills & Technologies

Onsite

Degree Required

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Health Care Service Corporation

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About Health Care Service Corporation

Health Care Service Corporation is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. It provides medical, dental, vision, life, and disability coverage to nearly 17 million members through individual, employer, and government programs. The company emphasizes community health investments, digital services, and value-based care initiatives. Founded in 1936 and headquartered in Chicago, HCSC is licensed as a mutual legal reserve company and governed by its policyholders.

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