Chronic Disease Coach, Registered Nurse
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Job Description
Chronic Disease Coach at BlueCross BlueShield of South Carolina providing support for wellness. Empowering members to achieve health goals and navigate healthcare benefits.
Responsibilities:
- Assess for needs related to a member’s chronic condition, clinical risk and readiness for change via company needs questionnaire
- Based on the needs assessment, complete and coordinate action plans in cooperation with members, then implement plans to include member goals
- Provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to elicit behavior change and increase member program engagement
- Participates in patient education with members and providers regarding the member’s condition and available benefit plans
- Serves as member advocate through continued communication and education
- Promotes enrollment in health and chronic condition management programs
- Provides appropriate communications (written, telephone) regarding member conditions to both health care providers and members
- Participates in data collection/input into system for clinical information flow
- Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal)
- Maintains current knowledge of network status of all service providers to educate members on care they may receive related to their chronic condition(s)
- Assists members with referrals to appropriate internal support areas to ensure proper processing of authorized or unauthorized services, as needed
Requirements:
- Associate's in job related field
- Graduate of Accredited School of Nursing OR graduate of a health-related degree OR 2 years job related work experience
- 3 years of professional health and wellness experience
- Working knowledge of word processing software
- Knowledge of quality improvement processes and demonstrated ability with these activities
- Knowledge of contract language and application
- 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
- Demonstrated oral and written communication skills
- Ability to persuade, negotiate, or influence others
- Analytical or critical thinking skills
- Ability to handle confidential or sensitive information with discretion
- Must get certification in health coaching within 4 years of hire (e.g., National Board-Certified Health and Wellness Coach)
Benefits:
- Subsidized health plans
- Dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Education Assistance
- Service Recognition
- National discounts to movies, theaters, zoos, theme parks and more
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