Internal Reference Number: R1047163
Summary Assists with implementation of health management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC) and/or BlueChoice members.
Description
Location: This position is full-time (40hours/week) Monday-Friday in atypical office environment. This role is onsite at 51 Clemson Rd. Columbia, SC Position Purpose: Supports the delivery and implementation of health management programs designed to improve outcomes and enhance the well-being of BlueCross BlueShield of South Carolina (BCBSSC) and BlueChoice members. What You'll Do:
Assists with implementation of health management activities/programs for membership. Coordinates all aspects of assigned programs. Facilitates program to participants and focuses emphasis on high-risk members. Follows/updates established procedures. Provides health coaching telephonically or in person for assigned health programs. Utilizes all data systems containing patient information and documents information appropriately. Assists with development of strategies to increase effectiveness of and participation in health management programs. Establishes/maintains effective communications with provider network, group representatives and members. Conducts research and analysis of reports (monthly, quarterly, annually). Adheres to policies and works toward attainment of program goals. Monitors member compliance and success rates. Assists with identification of areas for which there is a need for health management programs. Monitors quality indicators and develops programs to positively impact areas where improvement is warranted. Develops patient/provider educational materials for members/providers.
To Qualify For This Position, You'll Need The Following:
Required Education: Bachelors in a job-related field Degree Equivalency: If Maternity Management Coordinator/Counselor: 4-year degree in Health Promotion or related field OR 2-year degree and 2 years experience in healthcare environment or as a Certified Childbirth Educator/Prenatal Educator, OR graduate of an approved LPN program and 2 years experience in maternity management healthcare environment. If Diabetes Management Coordinator/Counselor: 4-year degree in Health Promotion, Nutrition, or related field or Certified Diabetes Educator OR graduate of an approved LPN program and 2 years experience in diabetes management healthcare environment. If Asthma Management Coordinator/Counselor: 4-year degree in Health Promotion, Exercise Science, or related field or Certified Asthma Educator or RRT (Registered Respiratory Therapist). If Wellness Coach/Health Promotion: 4-year degree in Health Administration, Health Promotion, Exercise Science, Education/Training, or health-related field. Required Work Experience: 3 years clinical in defined specialty and/or facilitating health education and prevention programs, OR, 4 years' experience in Health Administration or health-related field, OR, 2 years' experience if master's degree in Health Promotion, or Health Administration, or health-related field. Required Skills and Abilities: Working knowledge of word processing, spreadsheet, database, and presentation software. Understanding of insurance and benefit programs as it relates to health management coverage. Knowledge of the quality improvement process. Ability to work independently, prioritize effectively, and make sound decisions. Good judgment skills. Demonstrated customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar skills. Ability to persuade, negotiate, or influence others. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Microsoft Office. Required Licenses and Certificates: If RN, active, unrestricted RN licensure from the United States and in the state of hire, OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC); if LPN, active, unrestricted LPN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted LPN license as defined by the Nurse Licensure Compact (NLC).
We Prefer That You Have The Following:
Preferred Education: Bachelor's degree- Health Education/Health Management, Healthcare Administration, or Social Work, or Health Promotion. Preferred Work Experience: 3 years-healthcare program management. Preferred Skills and Abilities: Working knowledge of database software. Preferred Software and Other Tools: Working knowledge of Microsoft Access or other database software. Preferred Licenses and Certificates: Active, unrestricted LBSW (Licensed Bachelor of Social Work) licensure from the United States and in the state of hire.
*Work Environment: Typical office environment. May involve some travel. Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation. Some states have required notifications. Here's more information.
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