Aetna Health Coach Consultant (RN) - 59904BR in Sugar Land, Texas
Req ID: 59904BR
This is an in-office position open to candidates in the High Point, NC office or the Hartford, CT office. The hours are as follows: M-F, 3 days a week 9am-5:30 pm ET and 2 days a week 12:30-9 pm ET.
The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to life style changes to achieve and maintain optimal health status. Requires an RN with unrestricted active license. -Responsible for managing patients in a telephonic educational disease management program.
Fundamental Components included but are not limited to:
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.
Qualifications Requirements and Preferences:
3+ years of clinical experience required
RN with current unrestricted state licensure required.
Previous coaching experience preferred
Managed Care experience preferred
Strong computer skills preferred
Nursing - Registered Nurse
Nursing - Disease management, Nursing - Medical-Surgical Care
Computer Operation - System and Console Operations, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word
Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Maximizing Healthcare Quality, Leadership - Driving Change
General Business - Turning Data into Information, Leadership - Collaborating for Results
Additional Job Information:
Typical office working environment with productivity and quality expectations
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
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.
Registered Nurse with 3-5
years of clinical experience -Disease Management, Case Management or Managed
Care experience preferred -Excellent verbal and written communication skills
required to provide patient education -Proficiency in use of computer applications
and typing skills (>35 wpm) highly recommended -A commitment to Excellence
and Accountability -Integrity -Ability to be flexible and adapt to changing
processes and schedule requirements -Ability to work with multiple screens is
desired - This is a call center environment, majority of time is spent speaking
telephonically with members. -Bilingual in Spanish a plus, not required
-Willingness for flexible hours desired. -Work hours after orientation will be
from 9:00-5:30 EST 3 days/wk. and 12:30 pm to 9:00 pm EST 2 days/wk. There will
be a Friday evening rotation. This is a Monday through Friday schedule; no
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Health Care
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.