Holistic Health Specialist

Health Care Service Corporation

Holistic Health Specialist performing various functions to manage member care in a remote role. Consulting with health care personnel, promoting quality care, and providing member education.

Posted 7/8/2026full-timeRemote • Illinois, New Mexico, Oklahoma, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $61,500 - $136,100 per yearWebsite

About the role

Key responsibilities & impact

This position is responsible for performing a variety of functions and is a single source of contact for members, health care personnel and all other entities involved in managing care.
Identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs.
Promotes quality and cost-effective outcomes; and serves as liaison to physicians and members.
Other functions also include determining member assignment of treatment, and pre-admission/post-discharge counseling for an acute condition.
Establish relationship with the members.
Handle immediate post discharge follow-up or until all short-term care needs are met.
Provide education/local resource information and encourage member (self) education.
Functioning in a clinical care advisory role, assessing members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members.
Provide oversight to holistic health coordinators.

Requirements

What you’ll need

Registered Nurse (RN) with current, valid, unrestricted license in state of operations
2 years of clinical practice experience of direct clinical care to the customer
1 year of experience in care management/condition management in a health insurance/managed care setting
PC proficiency to include Word, Excel, Lotus Notes and database experience
Clear and concise verbal and written communication skills
Familiarity of ancillary services including HHC, SNF, Hospice, etc
Analytical skills
Decision making skills and sound clinical judgment to provide oversight of other staff
Must have an active and unrestricted Compact Nursing license.
Case Management experience is needed
Experience in managing complex or catastrophic health cases
Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management)
Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree
Knowledge of Milliman Guidelines or similar clinical guidelines
Knowledge of medical management policies and procedures

Benefits

Comp & perks

Health insurance
401(k) savings plan
Pension plan
Paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement
Other incentives

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Clinical CareCase ManagementCondition ManagementDisease ManagementHolistic Health CoordinationSpecialty Clinical ExperiencePC ProficiencyKnowledge of Milliman GuidelinesMedical Management PoliciesPost-Discharge Counseling

Soft Skills

Clear CommunicationRelationship BuildingSound Clinical Judgment

Certifications

Compact Nursing LicenseCCM CertificationCCP CertificationCDE CertificationMCG Certification