Provide care coordination to members via telephonic and/or field-based care management
Inform and educate members on health care programs to address personal health needs
Engage members in discussion of adherence to personal health goals
Respond to inquiries from members and support clinical operations with provider and member activities
Complete member telephonic and/or field-based health screenings that do not require clinical judgement
Perform care planning duties which may require visits to members’ homes and/or facilities
Develop written correspondence to members and department personnel
Use Microsoft Office applications and clinical systems to document and manage cases
Coach and educate members using motivational interviewing and patient education techniques
Coordinate with providers and other teams to manage member healthcare-related needs
Requirements
Bachelor’s degree in nursing, social work, counseling, human-services or social sciences OR LVN/LPN and 1 year of related experience OR 3 years of equivalent experience in managed care, a state care coordination or waiver program
Knowledge of healthcare terminology
Experience coordinating member healthcare related needs and analyzing member needs
PC proficiency including Microsoft Office applications and clinical systems
Customer service skills
Verbal and written communications skills, including developing written correspondence
Coaching skills, including motivational interviewing
Current unrestricted driver's license, transportation and applicable insurance
Direct clinical experience (preferred)
Experience with Developmental Disability & Fragile Waivers (preferred)
Patient education experience (preferred)
Condition Management experience (preferred)
Bilingual in English and Spanish (preferred)
Experience in managing complex or catastrophic cases (preferred)
Certification in Case Management, Training, Project Management or nationally recognized health care certification (preferred)
Government Programs experience (preferred)
This position requires onsite visits to members
Must reside within 250 miles of the office or anywhere within the posted state (Telecommute/Remote)
Benefits
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
Other incentives
Annual incentive bonus plan
Curated development plans and professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care coordinationhealth screeningscare planningmotivational interviewingpatient educationcondition managementanalyzing member needsmanaging complex caseshealthcare terminologybilingual in English and Spanish
Bachelor’s degreeLVNLPNCertification in Case ManagementTraining certificationProject Management certificationnationally recognized health care certification