Job Overview
Location
Work From Home (HB)
Job Type
Full-time
Category
Human Resources
Date Posted
May 7, 2026
Full Job Description
📋 Description
- • The Senior Manager, Clinical Review oversees daily operations of the Clinical Review Department in Healthcare Management, ensuring effective utilization management and claims medical management functions.
- • The role involves leading and supporting staff, analyzing healthcare data to identify trends and risks, and improving departmental efficiency and effectiveness through data-driven decision-making.
- • Health Care Service Corporation (HCSC) is a purpose-driven organization that invests in employee development, offering curated growth plans and a supportive work environment focused on meaningful careers.
- • The position provides opportunities to develop leadership expertise in clinical operations, enhance analytical skills in healthcare data interpretation, and drive process improvements that impact patient care and organizational performance.
🎯 Requirements
- • Bachelor’s Degree
- • Active state Registered Nurse license in good standing
- • 7 years of experience in direct clinical care or managed care
- • 3 years of management experience
- • Prior Utilization Management experience
- • Ability to communicate effectively in both oral and written forms
🏖️ Benefits
- • Health and wellness benefits
- • 401(k) savings plan
- • Pension plan
- • Paid time off and paid parental leave
- • Tuition reimbursement
- • Employee assistance program
Skills & Technologies
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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