Position Purpose With minimal supervision, assists to coordinate resources and educate the members that are enrolled in a disease management program. Relates effectively with others for continuity of care; maintains satisfactory relations with others, maintains accurate and complete records. Essential Position Functions Makes outbound calls to members in a disease management program to provide support, education and assistance as the member moves within the health care system Plans, implements, monitors, and evaluates health education programs Ensures member is receiving appropriate follow up and treatment, making lifestyle changes, and using self-management resources to avoid serious complications Collects and analyze data to learn about the effectiveness of the disease management program Advocate on behalf of the member regarding accessibility of services, assessing and interpreting member needs Relates effectively with co-workers regarding continuity of care and Care Management of members Maintains a professional approach with the highest standard of confidentiality Displays concern and initiative; Cooperates and maintains good rapport with staff, other departments, members, providers, and agencies involved in providing quality care to the member Work collaboratively with the Quality Department and CMO to provide feedback and improve outcomes related to HEDIS, Performance Improvement Projects (PIPs) and NCQA projects.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree