Job Description
This role involves:
-Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program.
-Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes.
-Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes.
The responsibilities include:
-Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act.
-Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients.
-Rotation in off-hour/weekend calls if applicable.
Qualifications:
-Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows.
-Experience navigating multiple EMR’s.
-Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.
About Guidehealth
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, improving patient health, and restoring provider fulfillment.