Description
THIS IS NOT A POSTING FOR A CURRENT OPEN POSITION BUT IS FOR CONSIDERATION OF POTENTIAL FUTURE JOB OPPORTUNITIES WITH WELLPOINT, INC.
This posting is in anticipation of future career opportunities with WellPoint, Inc. If and when openings become available and you are qualified for the position, you will be contacted via email.
HMC Nurses Change Lives
Come grow with us and help us build some healthier lives, including yours. Join the HMC family where employee well being and satisfaction is the core of our vision. Experience the refreshing difference of a HMC career.
HMC (Health Management Corporation) is a wholly owned subsidiary of WellPoint, Inc. The WellPoint family of companies provides health care benefits to approximately 34 million people and is the largest publicly traded commercial health benefits company in the United States.
Future Opportunities:
My Health Advantage: Respond to inbound calls from participants to assist them in accomplishing personal health goals. Assist with increasing participants motivational level by addressing barriers and assessing needs. Provide customer service support to callers in partnership with other departments.Responsible for conducting clinical education and wellness coaching for members with chronic conditions or other identified health needs to identify member knowledge, skills and behavioral needs, and gaps in care. This work is all completed from our working Call Center environment. Primary duties may include, but are not limited to: Perform health coaching for members with chronic conditions or other identified health needs. Implement and/or coordinate coaching care plans and discuss clinical health recommendations. Coordinate with the multidisciplinary clinical team regarding methods/approaches to help participants recognize and overcome barriers to improve their health. Manage provider office correspondence related to member health gaps. (Hours are typically part time 20 hours per week after training for this area.)
Complex Care: Performs care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs. Primary duties may include, but are not limited to: Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. Works with member to assess knowledge of condition, educates where necessary with goal of improving health and health behavior. Implements referrals as appropriate. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. Presents cases for discussion at Grand Rounds/Care Conferences. May require the development of a focused skill set including comprehensive knowledge of specific disease processes or traumatic injuries and may function as preceptor for new care management staff. May participate in department audit activities.
Disease Management/Condition Care: Participates in delivery of patient education and disease management interventions and performs health coaching for members, across multiple lines, for health improvement/management programs for chronic diseases. Essential duties may include, but are not limited to: Conducts behavioral or clinical assessments to identify individual member knowledge, skills and behavioral needs. Identifies and/or coordinates specific health coaching plan needs to address objectives and goals identified during assessments. Interfaces with provider and other health professionals to coordinate health coaching plan for the member. Implements and/or coordinates coaching and/or care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. Uses motivational interviewing to facilitate health behavior change. Monitors and evaluates effectiveness of interventions and/or health coaching plans and modifies as needed. Directs members to facilities, community agencies and appropriate provider/network. Refers member to catastrophic case management as appropriate.
Hours: Monday-Friday 8:30am-5p.m. during training. Most new opportunities are for evening hours (working until 9p.m. and also requires working one Saturday per month.) LOCATION: 7600 E. Eastman Ave. Denver, CO
Qualifications
* As business needs may require, this position may require additional state licenses either now or in the future. Inability or unwillingness to obtain these required licenses may result in either re-assignment (if available) or termination. Obtaining required licenses is a requirement for continued employment
* Current unrestricted Colorado RN license and 2-3 years of condition specific clinical or home health/discharge planning experience or any combination of education and experience which would provide an equivalent background. (Complex Care area requires
* 5 years clinical experience.
*
Hours during initial training will be full time 40 hours per week 8:30am-5pm Monday - Friday. After this available shifts include:
Full Time: 12:30-9pm (5 days), 10:30am-9pm (4 days) or a Split Shift between a.m. and p.m. hours. MHA area - Part Time 20 hours per week. Also one Saturday per month.
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This position is a staff level position as an RN within a Call Center environment.
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Requires strong oral and written communication skills, analytical and research skills, motivational skills, and PC skills to include word processing, spreadsheet, and database applications, organizational and problem-solving skills, and decision-making skills.
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Prior case management experience preferred. (Required for Complex Care).
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Medicare experience an added plus
* Complex Care area also requires: Knowledge of health insurance/benefits, care management assessment technique, provider community, and community resources. This level manages the most complex cases, may participate in department audit activities, serve as preceptor for new associates and participate in or lead projects with cross-functional teams. Complex Care prefers Case management certification.
Details:
Job Id:
40691
Annual Salary:
Position Type:
Education Level:
No Selection
Experience Level:
No selection
Posted:
7/18/2009 9:24:23 PM
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