RN Clinical Care Guide- Scottsdale (Case Management Experience Required) (Onsite)

Blue Cross Blue Shield of Arizona•Scottsdale, AZ

51d•Onsite

About The Position

The Clinical Care Guide (RN) will be a key contributor to our first-class care team at Prosano Health Solutions. They will deliver on our commitment to excellence to our patients and help us grow through their role. The Clinical Care Guide will have end to end responsibility for our specialist and diagnostic testing navigation, as well as in leading and partnering with the care team in supporting patients in their journey toward their best health. This position has an emphasis on customer/patient care excellence, privacy, compliance, and serving in a dynamic health setting. Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments Play a critical role in the achievement of improved health outcomes and cost savings Be an empathetic problem-solver and become the most visible partner to all patients Clarify and explain referral for specialist and diagnostic service recommendations Care for end to end process as needed, for referral or specialist services Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs Support members with chronic conditions by providing education, reminders, and other support Handle the management and integration of office processes Lead service and schedule requests on member’s behalf Inform and equip Care Team with referral information and requirements Be an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partners Perform all other duties as assigned Working hours may include extended hours. This position requires 100% on-site work at the care center location and may also involve movement between clinics as needed

Requirements

Excellent interpersonal skills to include maintaining courteous, friendly and effective communications with patients, team members and external parties
Current state license to practice as a Registered Nurse
BLS certification
Electronic Medicare Records experience
Customer service orientation and experience
Strong communication skills across multiple modalities
Highly collaborative
Empathy and advocacy
Exceptional organizing skills, detail-orientation
Must be able to maintain confidentiality at all times
Active AZ fingerprint clearance card

Nice To Haves

Bachelor's degree in Nursing (BSN)
Case Management Certification (CCM)
Proficiency with other health care related software platforms
High degree of independence, flexibility, initiative and commitment

Responsibilities

Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments
Play a critical role in the achievement of improved health outcomes and cost savings
Be an empathetic problem-solver and become the most visible partner to all patients
Clarify and explain referral for specialist and diagnostic service recommendations
Care for end to end process as needed, for referral or specialist services
Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs
Support members with chronic conditions by providing education, reminders, and other support
Handle the management and integration of office processes
Lead service and schedule requests on member’s behalf
Inform and equip Care Team with referral information and requirements
Be an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partners
Perform all other duties as assigned