In this role, you will be responsible for assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
In this role, the selected candidate will manage a core function within the Customer Service Department (Research or Direct Customer Contact); resolve complex customer issues that are beyond the scope of the Customer Service Sr. Resolution Specialist.
In this role, the selected candidate will be responsible for providing home health aide competency evaluations and in-service in accordance with federal guidelines; responsible for monitoring satisfaction surveys to identify trends and resolve problem areas.
Responsible for leading the real-time monitoring of contact center performance, making recommendations and optimizing usage of contact center routing, resources, and communicating real-time and intra-day performance.
In this role, you will educate member on topics related to their chronic condition and the disease process; including all aspects of effective self-management (medication, diet and nutritional monitoring; foot care, prevention and care of complications; recommended screenings, blood glucose monitoring and the techniques of self monitoring and insulin injections).
In this role, you will be responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs.