Health Coach ConsultantPrimary Location: Sugar Land, Texas
Additional Locations: CT-Hartford, TX-Sugar Land Apply
61517Fundamental Components: Assessment of Members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member's needs and benefit plan eligibility for available integrated internal and external programs/services. Utilizes assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change. Enhancement of Medical Appropriateness & Quality of Care.
Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external programs. Using holistic approach consults with supervisors, Medical Directors and/or others to overcome barriers to meeting goals and objectives. Identifies and escalates quality of care issues through established channels. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Interprets and utilizes clinical guidelines/criteria to positively impact members health Provides up-to-date healthcare information to help facilitate the member¡¦s understanding of his/her health status Helps member actively and knowledgably participate with their provider in healthcare decision-making Monitoring, Evaluation and Documentation of Care Develops and monitors established plans of care, in collaboration with the member and/or attending physician, to meet the member's goals. Utilizes internal policy and procedure in compliance with regulatory and accreditation guidelines. Background Experience: 3+ years of clinical experience required
RN with current unrestricted state licensure required
Previous coaching experience preferred
Managed Care experience preferred. Additional Job Information: Typical office working environment with productivity and quality expectations Work requires the ability to perform telephonic assessments and documentation during the assessment call. Work requires sitting for extended periods, performing assessments, making outbound calls to introduce our program and being available to take calls from the queue. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written.
Aetna is about more
than just doing a job. This is our opportunity to re-shape healthcare for
America and across the globe. We are developing solutions to improve the
quality and affordability of healthcare. What we do will benefit generations to
come. We care about each other, our customers and our communities. We are
inspired to make a difference, and we are committed to integrity and
excellence. Together we will empower people to live healthier lives. Aetna is
an equal opportunity & affirmative action employer. All qualified
applicants will receive consideration for employment regardless of personal
characteristics or status. We take affirmative action to recruit, select and
develop women, people of color, veterans and individuals with disabilities. We
are a company built on excellence. We have a culture that values growth,
achievement and diversity and a workplace where your voice can be heard. Required Skills: Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts, Leadership - Driving Change Desired Skills: General Business - Turning Data into Information, Leadership - Collaborating for Results Functional Skills: Nursing - Disease management, Nursing - Medical-Surgical Care Technology Experience: Computer Operation - System and Console Operations, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word Education: Nursing - Registered Nurse (RN) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
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