Care Specialist
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries. The Care manager works closely with members and their caregivers to promote habits to improve quality of life and attainment of health goals using a Whole Person Care approach. The Care Manager creates a customized plan to meet the clients’ key risks through collaborative approach with the clients and their caregivers. The Care Manager is responsible for developing a health coaching relationship with members and assisting the member through the process of actively working towards better health by providing support, encouragement, and education on chronic conditions. The Care Manager supports coordination of care and condition management activities with members, caregivers, and providers. Essential Functions:
- Develop a trusting relationship with members to support the member through the process of changing behavior and improving management of their health by utilizing motivational interviewing techniques and change management concepts.
- Assist in coordinating members’ relationships with multiple service systems. This may include activities such as:
- Educational resources
o Recommendations for functional adaptations, durable medical equipment, and care coordination for other skilled interventions and preventive services.
- Present health education in a culturally appropriate format. For example, teaching a member how to prepare traditional foods using less fat
- Provide social support to improve members’ adherence to medical treatment plan
- Encourage the member in adoption of habits that are conducive to improved management of their chronic condition
- Develop an individualized plan including goals and plan of action
- Serve as a resource to Care Management team members
Job Requirements: Education: College degree in a health-related field preferred Professional Qualification: Certification may be required per client contract. Current and unrestricted OTA license/certification may be required LPN/LVN may be required Experience: Minimum 1-3 years’ clinical experience with patient assessments. Experience utilizing Motivational Interviewing techniques and behavioral change theory to facilitate member adoption of positive changes and improve health. Experience working with the Medicare population. Functional/Technical Knowledge, Skills and Abilities Required: With Moderate Competency Level in the ff.: 1. Excellent interpersonal skills 2. Ability to understand and interpret policy provisions. 3. Product knowledge 4. Typing Skills 5. Problem Solving Skills 6. Proficient computer skills 7. Demonstrates empathy 8. Strong organizational skills In addition: Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible Ability to assist member in navigating the healthcare system and community-based resources Culturally sensitive and competent for assigned membership Strong organizational skills; ability to multi-task and be nimble Ability to work remotely Ability to determine when to escalate issues appropriately and in a timely manner Job title: Care Specialist Job Description: Essential Functions:
- Develop a trusting relationship with members to support the member through the process of changing behavior and improving management of their health by utilizing motivational interviewing techniques and change management concepts.
- Assist in coordinating members’ relationships with multiple service systems. This may include activities such as:
- Educational resources
o Recommendations for functional adaptations, durable medical equipment, and care coordination for other skilled interventions and preventive services.
- Present health education in a culturally appropriate format. For example, teaching a member how to prepare traditional foods using less fat
- Provide social support to improve members’ adherence to medical treatment plan
- Encourage the member in adoption of habits that are conducive to improved management of their chronic condition
- Develop an individualized plan including goals and plan of action
- Serve as a resource to Care Management team members
Location: Work@Home USAUnited States of America