- Where
- Columbia, South Carolina
- Level
- Mid
Summary
Assists with implementation of health management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC) and/or BlueChoice members.
Description
Location: This position is full-time (40hours/week) Monday-Friday in atypical office environment. This role is onsite at 51 Clemson Rd. Columbia, SC
Position Purpose: Supports the delivery and implementation of health management programs designed to improve outcomes and enhance the well-being of BlueCross BlueShield of South Carolina (BCBSSC) and BlueChoice members.
What You'll Do:
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. Provides health coaching telephonically or in person for assigned health programs. Utilizes all data systems containing patient information and documents information appropriately.
Assists with development of strategies to increase effectiveness of and participation in health management programs. Establishes/maintains effective communications with provider network, group representatives and members.
Conducts research and analysis of reports (monthly, quarterly, annually). Adheres to policies and works toward attainment of program goals. Monitors member compliance and success rates.
Assists with 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.
To Qualify For This Position, You’ll Need The Following:
Required Education: Bachelors in a job-related field
Degree Equivalency: 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 Work Experience: 3 years clinical in defined specialty and/or facilitating health education and prevention programs, OR, 4 years' experience in Health Administration or health-related field, OR, 2 years' experience if master's degree in Health Promotion, or Health Administration, or health-related field.
Required Skills and Abilities : Working knowledge of word processing, spreadsheet, database, and presentation software. Understanding of insurance and benefit programs as it relates to health management coverage. Knowledge of the quality improvement process. Ability to work independently, prioritize effectively, and make sound decisions. Good judgment skills. Demonstrated customer service, organizational, and presentation 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: Microsoft Office.
Required Licenses and Certificates: If RN, active, unrestricted RN licensure from the United States and in the state of hire, OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC); if LPN, active,…