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Role Description

The Health Coach telephonically outreaches our Medicare population to improve medication adherence and/or HEDIS diabetes and blood pressure control, providing education and addressing any barriers to adherence by utilizing the member's benefits. This may include outreach to pharmacies and prescribers.

• Utilizes a collaborative process of assessment, planning, implementation, and coordination to engage, educate, and promote/influence members in decisions related to achieving and maintaining optimal health status.
• Assessment of Members:
  • Through motivational interviewing and the use of various tools, evaluates member's health status for either HEDIS health screening/control or Medication Adherence.
  • Utilizes influencing/motivational interviewing skills to ensure member engagement and discern health needs based on key questions and conversation to promote behavior changes to achieve optimum level of health.
• Partners with members to identify opportunities for integration into available internal/external programs.
• Using a holistic approach, consults with Manager or others to overcome barriers with assisting members in meeting goals and objectives.
• Utilizing interviewing and active listening skills, provides coaching, information, and support to empower the member to make ongoing independent healthy healthcare choices.
• Interprets and utilizes guidelines/criteria to positively impact members' health.
• Provides up-to-date healthcare information to help facilitate the member’s understanding of his/her health status.
• Helps member actively and knowledgeably participate with their provider in healthcare decisions.
• Applies judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact healthcare access, services, and resolution of member issues.
• Develops a proactive course of action to address issues presented to enhance the short and long-term health outcomes as well as opportunities to enhance a member’s overall wellness through integration.

Qualifications

• 1-3 years Microsoft Office experience.
• 3-5 years practice experience in Renal, Diabetes, Hypertension, Primary Care/Geriatric, Oncology.
• Managed Care and Medicare experience.

Requirements

• Healthcare licensure and/or certifications (RN, LPN, MSW, LCSW, CDE, etc.) highly preferred.
• 5 years practice experience in Renal, Diabetes, Hypertension, Primary Care/Geriatric, Oncology.
• Previous telephonic coaching, education or case management experience.
• Excellent computer skills including MS Office applications.
• Independent worker.
• Excellent time management skills.
• Excellent analytical and problem-solving skills.
• Effective communications, organizational, and interpersonal skills.
• Bilingual a plus.
• Demonstrated ability to communicate, problem solve, and work effectively with people, using good judgment in challenging situations.
• Experience in facilitating client positive behavioral change.
• Background in motivational interviewing and active listening skills.

Education

• Associates Degree or equivalent experience.

Benefits

• Affordable medical plan options.
• 401(k) plan (including matching company contributions).
• Employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling, and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access, and many other benefits depending on eligibility.