Case Manager RNPrimary Location: New Albany, Ohio
Additional Locations: OH-New Albany Apply
The Clinical Services Advocate is part of a dedicated team of clinical and service professionals empowered to take care of all aspects of a members health. Clinical Services Advocates are responsible for providing personalized, end to end member support including coordination of health care services, decision support, benefits support, complex case management and chronic condition management. Clinical Service Advocates serve as a single point of contact to help the member and family maximize benefits and easily navigate the health care system. The Clinical Advocate provides the member with a powerful and proactive experience through high touch, personalized communications designed to help the member achieve their health ambition.
60345Fundamental Components: Fundamental components include but are not limited to;
Facilitate the ongoing coordination and delivery of health care services to enhance a members health, wellness and achieve quality outcomes. Effectively engage members using omni-channel communication mechanisms (phone,email, chat, text, IM). Develop a personalized plan with member based on their health ambition and communication preferences. Serve as single point of contact for the member and enrolled family. Assist with effective use of health care benefits, access to available programs/services and determining next best actions to achieve health ambitions. Conduct proactive outreach to at risk members and leverage available data to identify actionable health needs. Holistically assess members needs and collaborate with treating providers, vendor partners and other Advocate team members to formulate care plans and coordinate services. Develop personalized, creative solutions to help members meet their health care needs. Assist members to prioritize health goals to achieve positive outcomes and health ambitions. Build strong, trusting relationships by fully understanding the members needs and goals Background Experience:
3+ years clinical practice experience required
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