Upvote
Downvote
Registered Nurse
Share Job
- Suggest Revision
$31 an hour
- Provides telephonic support for members with chronic conditions, high risk pregnancy or other at-risk conditions that consist of intensive assessment/evaluation of condition, at risk education based on members’ identified needs, provides member-cantered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behaviour change and increase member program engagement.
- Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc
- Participates in data collection/input into system for clinical information flow and proper claims adjudication.
- 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).
- Promotes enrolment in care management programs and/or health and disease management programs.
Active Job
Updated 5 days agoSimilar Job
Relevance
Active