- This role will be On-site at our
- 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 in order to provide the most effective and efficient customer service.
- Collaborating with various 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; e.g. assists with access to care issues.
- Providing referrals to community resources such as elder care.
- Educating prospective customers and members on benefits structure and care setting alternatives.
- Educating prospective customers and members and helping them access and understand 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
- 1 years nursing experience
- Bilingual Spanish/English
- Knowledge and understanding of benefit plans
- Must be willing to work flexible hours to include evenings,
- Knowledge of healthcare continuum
- Experience with automated medical systems
- Health Coaching
- RN - Registered Nurse - State Licensure And/Or Compact State Licensure Active Florida RN license Upon Hire
- Certified Health Coach, CHC 180 Days
- BCLS - Basic Life Support CPR Certification Upon Hire
- Related bachelor's degree, Social Work preferred.
- 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 benefit plans 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 resources
- Medical, dental, vision, life, and global travel health insurance.
- Income protection benefits: life insurance, Short- and long-term disability programs.
- Leave programs to support personal circumstances.
- Retirement Savings Plan includes employer contribution and employer match.
- Paid time off, volunteer time off, and 11 holidays
- Additional voluntary benefits available; and
- A comprehensive wellness programs
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Bilingual Florida Blue Center Nurse RN - Clermont, FL, United States - Blue Cross and Blue Shield Association
Description
Bilingual Florida Blue Center Nurse RN
Get to know us
Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years.
Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state.
We are looking for exceptional people who will bring our mission to life and succeed by putting the member first.
Let's talk benefits
When it comes to our benefits, we offer a total compensation package including competitive base pay, health insurance, 401(k), as well as work-life balance programs, flexible work arrangements, and opportunities for growth and development.
What you will do:
Love engaging with people to help them achieve better health? Come join the exciting, rapidly expanding Direct-to-Consumer team.
We make it our priority to utilize our skills and knowledge to help members make positive changes in their health and well-being.
While on this team you will proactively 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.
Important to know:
Hours of Operation:
Monday - Friday 9:00 a.m. - 7:00 p.m. Saturday 9:00 a.m. - 4:00 p.m.
The essential functions listed represent the major duties of this role, additional duties may be assigned:
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:
What you will need:
Experience:
Licenses and/or Certifications:
Education:
What We Prefer:
When you become part of the GuideWell family, you help bring our mission to life by helping people and communities achieve better health.
General Physical Demands:
Sedentary work:
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 communities.
What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.
As an employee, you will have access to:
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Annualized Salary Range:
$65,600 - $106,600
Typical Annualized Hiring Range:
$65,600-82,000
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities.
