RN - Navigation Nurse Florida Blue Retail Center (Sarasota, FL)
Company: GuideWell
Location: Sarasota
Posted on: May 12, 2022
Job Description:
What Will Be Your PurposeProactively manage prospective
customers and members' experience through the health care continuum
and delivery system in a Florida Blue Center environment by
assessing needs, educating on benefit plans, costs, choices, tools,
and programs, and referring to Florida Blue programs and resources
as appropriate. Contacts and referrals can come from a variety of
internal and external sources, including member self-service, Care
Managers, the member contact center, third party vendors such as
Health Dialog, wellness/health fairs and GuideWell Enterprise
Channels. Present health education classes and programs to members
and non-members. Perform Personal Health Assessments on members and
provide education on ways to achieve better health.Important to
Know
- Must reside in Sarasota, FL or surrounding area
- Requires the following Licenses & Certifications
- RN State Licensure Upon Hire
- Health and Life Insurance License
- BCLS - Basic Life Support CPR Certification Upon Hire
- Health Coaching Certification within 180 Days of Hire
- Must be able to work events in/outside of the center, 1
Saturday a month and 1-2 evenings per week (10:30am-7:30pm).
- Bilingual is a plusWhat Will Be Your Purpose?Provides personal,
Care engagement and assistance with coordination of health care
benefits and services to prospective customers and members in the
Direct-to-Consumer Channel by:
- Performing Personal Health Assessments and providing education
on the biometric results
- Closing member care gaps by accurately documenting test results
in the clinical record
- Presenting health education classes and programs
- Performing prospective customer and member needs assessment to
provide the most effective and efficient customer service.
- Collaborating with various internal teams to improve the
Enterprise STARS rating through targeted member campaigns.
- Participating in outbound call campaigns to members for
Enterprise Partners, including Commercial, U65, and Medicare
teams.
- Facilitating benefit savings for members by proactively
educating them on benefit plan impacts and choices.
- Facilitating problem solving and issue resolution with access
to care issues.
- Providing referrals to community resources such as elder
care.
- Educating prospective customers and members on benefits
structure, care setting alternatives, accessing, and understanding
cost and quality comparisons.
- Providing appropriate referrals to other corporate programs
such as, Healthy Addition, New Directions and Care Management.
- Coordinating care for members as appropriate using a
personalized care plan.
- Host Customer Video Appointments.
- Educate members on digital platforms such as Blue for Me and
MeQuilibrium
- Performs other duties as assigned.What You Must Have
- 1+ years related work experience Nursing, Health Educator
- High school diploma or GED
- Required Licenses and Certifications
- Registered Nurse (RN) State Licensure and/or Compact State
Licensure Active Florida RN license Upon Hire
- Basic Life Support CPR Certification (BCLS) Upon Hire
- Health Coaching Certification Upon 180 Days of being Hired
- Knowledge and understanding of benefit plans and healthcare
continuum
- Experience with automated medical systems
- 3 or more years' managed care, case management, disease
managements, clinical nursing, home health care or related
experience with hands-on patient interaction
- Sales work experience
- Knowledge of provider contracting and reimbursement
methodologies
- Knowledge of member tools such as the Member Portal
- Knowledge of care management, disease management and similar
care programs
- Knowledge of health and specialty products and ability to
inform others of how to use benefits in conjunction with specific
illnesses
- Knowledge of community resourcesWhat We Prefer
- Associate Degree in Nursing (ADN)
- Experience as a point of contact for referring physicians,
patients, and caregivers to provide resources and assistance with
accessing clinical and supportive care services.
- Proven experience maintaining and continually building rapport
and trust with our community partners, agencies, and members.
- Excellent presentation skills to deliver training, and host
speaking engagements when promoting our plansGeneral Physical
Demands
- Exerting up to 10 pounds of force occasionally to move
objects.
- Jobs are sedentary if traversing activities are required only
occasionally.We are an Equal Opportunity/Protected Veteran/Disabled
Employer committed to creating a diverse, inclusive, and equitable
culture for our employees and communitie
Keywords: GuideWell, Sarasota , RN - Navigation Nurse Florida Blue Retail Center (Sarasota, FL), Hospitality & Tourism , Sarasota, Florida
Didn't find what you're looking for? Search again!
Loading more jobs...