Member Advocate

Vheda Health

95d

About The Position

We are hiring a Member Advocate to join our team! In this role, you will maintain knowledge and use critical thinking to effectively triage, delegate, identify risks, and close gaps in care. You will contact members who may have out-of-range vital signs or device readings and assess potential immediate health needs to determine urgency. Additionally, you will remind members of available resources, delegate to a higher level of care if indicated, and document all conversations. You will receive data in real-time through remote patient monitoring devices and will be fully supported by our online platform, including data and technology that ensures the highest care plan adherence. Your responsibilities will also include providing telephonic consultation to assigned patient cohorts to triage and assess for disposition, consulting with individual members who are non-compliant with a focus on reengagement, and collaborating with clinical services, health coaching, and member support teams to coordinate services for assigned patient cohorts. You will develop, communicate, and maintain strong working relationships with the clinical services team, providing support and consultation as needed. Furthermore, you will facilitate and/or delegate patient education in support of standards of care and best practices related to health conditions using the most appropriate modality for the member. You will assist members with mobile care management devices and maximize member access to available resources while conveying general knowledge of chronic disease management and progression (Diabetes, Hypertension, Congestive Heart Failure, Asthma, COPD, Weight Management, Mental/Behavioral Health). Lastly, you will support activities related to HEDIS and/or NCQA communication and measures, conduct care team telephonic outreach with providers and/or providers with members, and maintain Medicaid and/or Medicare knowledge.

Requirements

• Proficiency with technology/computers in web-based applications.
• Ability to work closely with member and care team.
• Ability to effectively communicate with team, members, and support persons.
• Ability to display exceptional interpersonal, organization and communication skills, while showing compassion and empathy.
• Ability to work with diverse populations.

Responsibilities

• Maintain knowledge and use critical thinking to effectively triage, delegate, identify risks and close gaps in care.
• Contact members who may have out-of-range vital signs or device readings.
• Assess potential immediate health needs to determine urgency, remind members of available resources, delegate to higher level of care if indicated, and document all conversations.
• Receive data in real time through remote patient monitoring devices.
• Provide telephonic consultation to assigned patient cohorts to triage and assess for disposition.
• Consult with individual members who are non-compliant, focusing on reengagement.
• Collaborate with clinical services, health coaching, and member support teams to coordinate services for assigned patient cohorts.
• Develop, communicate, and maintain strong working relationships with the clinical services team, providing support and consultation as needed.
• Facilitate and/or delegate patient education in support of standards of care and best practices related to health conditions using the most appropriate modality for the member.
• Coordinate member education in support of standards of care and best practices related to health issues using the most appropriate modality for the member.
• Assist members with mobile care management devices and maximize member access to available resources.
• Convey general knowledge of chronic disease management and progression (Diabetes, Hypertension, Congestive Heart Failure, Asthma, COPD, Weight Management, Mental/Behavioral Health).
• Support activities related to HEDIS and/or NCQA communication and measures.
• Conduct care team telephonic outreach with provider and/or provider with member.
• Maintain Medicaid and/or Medicare knowledge.

Benefits

• Competitive base salary
• Location flexibility
• Paid certification training

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 51-100 employees