Health Guide
Company: Prime Therapeutics
Location: Baton Rouge
Posted on: May 6, 2024
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Job Description:
Our work matters. We help people get the medicine they need to
feel better and live well. We do not lose sight of that. It fuels
our passion and drives every decision we make.
Job Posting Title
Health Guide
Job Description Summary
Provides ongoing, community-based support for an assigned caseload
of health plan enrollees to improve access to care and care
coordination. Establishes a relationship with the enrollee, the
care coordination team, and providers. Conducts new enrollee
outreach and orientation, arranges appointments and transportation
as needed. Assists the enrollee in learning to navigate the health
care delivery system, community resources, transportation, and
effectively use health plan benefits.
Job Description
Conducts outreach and orientation for new enrollees. Gathers
information needed to ensure continuity of care and permission to
share information.
Administers Health and Wellness Questionnaire.
Seeks connection by working with the Peer Support Specialist and
leveraging community services, care providers, family members,
schools, etc.
Assists enrollees in accessing care and ensures care is received.
Helps members, as needed, in selecting providers, making
appointments, and planning transportation.
Contacts enrollee or provider to ensure appointments have occurred.
Assists in transitions of care to and from alternative levels of
care or settings.
Makes follow up care arrangements and ensures post-hospital care is
delivered as planned.
Meets with enrollee regularly (as determined by individual risks)
in order to monitor progress according to the Care Coordination
Plan.
Reminds enrollee of self-management tools and crisis support.
Informs and engages the Care Coordination Team if enrollee has
difficulty adhering to the care coordination plan or adhering to
treatment and needs additional support.
Works with enrollee and family/supports to engage in socialization,
work or volunteer related activities, or access community resources
and services.
Maintains up to date documentation in the Care Coordination Plan
and other Health Services tools.
Prepares information for Care Coordination Team meetings and as
requested, for shared treatment planning sessions.
Responsibilities
Ability to review and interpret multiple contract/account
information to successfully resolve issues regarding benefit plan
administration; experience with account benefit structures.
Demonstrated ability for problem solving, meeting deadlines,
initiative and follow-through.
Excellent written and verbal communication skills.
Knowledge of pharmacy benefits management.
Understanding of customer service performance metrics (ASA,
abandonment rate, talk time).
Work Experience
Work Experience - Required:
Customer Service
Work Experience - Preferred:
Managed Healthcare
Education
Education - Required:
GED, High School
Education - Preferred:
Bachelors
Certifications
Certifications - Required:
Certifications - Preferred:
Potential pay for this position ranges from $18.87 - $28.30 based
on experience and skills. Pay range may vary by 8% depending on
applicant location.
To review our Benefits, Incentives and Additional Compensation,
visit our Benefits Page
(https://www.primetherapeutics.com/careers/benefits/) and click on
the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer and a
Tobacco-free workplace. We encourage diverse candidates to apply
and all qualified applicants will receive consideration for
employment without regard to race, color, religion, sex (including
pregnancy), sexual orientation, gender identity or expression,
genetic information, marital status, family status, national
origin, age, disability, veteran status, or any other legally
protected class under federal, state, or local law. Every employee
must understand, comply with and attest to the security
responsibilities and security controls unique to their position;
and comply with all applicable legal, regulatory, and contractual
requirements and internal policies and procedures.
Positions will be posted for a minimum of five consecutive
workdays.
Prime Therapeutics' fast-paced and dynamic work environment is
ideal for proactively addressing the constant changes in today's
health care industry. Our employees are involved, empowered, and
rewarded for their achievements. We value new ideas and work
collaboratively to provide the highest quality of care and service
to our members.
If you are looking to advance your career within a growing,
team-oriented, award-winning company, apply to Prime Therapeutics
today and start making a difference in people's lives.
Prime Therapeutics LLC is an Equal Opportunity Employer. We
encourage diverse candidates to apply and all qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, national
origin, disability, or veteran status. --- If you are an applicant
with a disability and need a reasonable accommodation for any part
of the employment process, please contact Human Resources at
1.866.469.1257 or email Careers@primetherapeutics.com.
Keywords: Prime Therapeutics, Alexandria , Health Guide, Healthcare , Baton Rouge, Louisiana
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