Duties/Responsibilities:

Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.

Conducts assessments to identify barriers and opportunities for intervention.

Develops care plans that align with the physicians treatment plans and recommends interventions that align with proposed goals.

Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement.

Collaborates with provider doctors, social workers, discharge planners, and community based service providers to coordinate care accordingly.

Coordinates and facilitates with the multi-disciplinary health care team as necessary in order to ensure care plan goals are achieved and maximize member outcomes.

Assists in identifying opportunities for alternative care options based on member needs and assessments.

Evaluates service authorizations to ensure alignment and execution of the members care and physician treatment plan.

Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.

Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.

Occasional overtime as necessary.

Additional duties as assigned.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.