Description:
- Assists with implementation of health management activities/programs for Client. 50% Assists with implementation of health management activities/programs for membership.
- Coordinates all aspects of assigned programs.
- Facilitates program to participants and focuses emphasis on high-risk members. Follows/updates established procedures. Conducts research and analysis of reports (monthly, quarterly, annually).
- 25% Assists with the development of strategies to increase effectiveness of and participation in health management programs. Establishes/maintains effective communications with provider network, group, representatives, and members.
- 15% Provides health coaching telephonically or in person for assigned health programs. Utilizes all data systems containing patient information and documents information appropriately.
- 10% Assists with the identification of areas for which there is a need for health management programs. Monitors quality indicators and develops programs to positively impact areas where improvement is warranted. Develops patient/provider educational materials for members/providers.
Required Skills and Abilities:
- Ability to work independently, prioritize effectively, and make sound decisions.
- Good judgment skills. Demonstrated customer service and organizational skills.
- Demonstrated proficiency in spelling, punctuation, and grammar skills. Ability to persuade, negotiate, or influence others.
- Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion.
Required Software and Tools:
Preferred Skills and Abilities:
- Understanding of HMO operations/benefit programs, how it relates to health management coverage.
- Knowledge of the quality improvement process.
Preferred Software and Other Tools:
- Working knowledge of Microsoft Access or other database software.
Work Environment:
- Typical office environment.
- May involve some travel.
Education:
- Required Education: Bachelor's Degree in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or health-related field.
- or If Maternity Management Coordinator/Counselor: 4-year degree in Health Promotion or related field OR 2-year degree and 2 years experience in healthcare environment or as a Certified Childbirth Educator/Prenatal Educator, OR graduate of an approved LPN program and 2 years experience in maternity management healthcare environment.
- If Diabetes Management Coordinator/Counselor: 4-year degree in Health Promotion, Nutrition, or related field or Certified Diabetes Educator OR graduate of an approved LPN program and 2 years experience in diabetes management healthcare environment.
- If Asthma Management Coordinator/Counselor: 4-year degree in Health Promotion, Exercise Science, or related field or Certified Asthma Educator or RRT (Registered Respiratory Therapist).
- If Wellness Coach/Health Promotion: 4-year degree in Health Administration, Health Promotion, Exercise Science, Education/Training, or health-related field.
Required Experience:
- 1 year clinical in defined specialty and/or facilitating health education and prevention programs; OR, 2 years experience in Health Administration, or health-related field.
Preferred Education:
- Bachelor's degree - Health Education/Health Management, Healthcare Administration, Social Work, or Health Promotion.
Preferred Work Experience:
- 3 years healthcare program management.
Preferred Licenses and Certificates:
- Active, unrestricted LBSW (Licensed Bachelor of Social Work) licensure from the United States and in the state of hire.