Care Advocate II
Remote within WA, ID, OR, and UT
Primary Job Purpose:
The Care Advocate II participates in the coordinated approach to care management for members. This role provides outreach as part of specific Maternity Care initiatives or as an ongoing part of a care management team. The position works with members to achieve their personal health outcomes by removing barriers and providing support and education. The Care Advocate II encourages engagement in health-related activities and programs and provides appropriate referrals to internal or external services and resources.
Normally to be proficient in the competencies listed below:
The Care Advocate II would have an Associate's degree or clinical certification such as a CNA or Medical Assistant, and 5 years of health-related experience including at least 2 years of Care Advocate or similar experience, or an equivalent combination of education and experience.
- Connects with members identified for the Regence Care Management Programs via outbound phone calls or emails.
- Applies motivational interviewing and behavioral change principles to encourage engagement in health-related activities and programs.
- Educates members by providing the tools and information they need to participate in nationally recognized preventive screenings, discharge, and treatment plans.
- Works with a Care Manager to assure that member needs are met through identification and referral to appropriate resources, including referrals to licensed clinical staff (as appropriate).
- Uses the applicable care management platform to appropriately record and track member interactions.
- Initiates outbound telephone calls to members in potentially complex healthcare situations (e.g. hospital discharge or admission to skilled nursing facility).
- Provides members with support, reassurance, and education to improve the member's ability to make informed healthcare decisions, navigate care options, and to take actions in order to improve well-being and prevent/minimize disease.
- May assist with activities in support of the Clinical Services Team, including but not limited to program communications and training.
- Identifies areas in need of improvement in all aspects of the program, and provides recommendations for solutions.
- Strong communication skills with the ability to effectively interact with a wide variety of individuals on highly sensitive topics.
- Strong customer service skills including active listening, patience, and compassion, all while maintaining confidentiality.
- General organization, data entry and administrative skills.
- Proven track record of successfully handling multiple tasks and prioritizing workload.
- General digital literacy (including use of Microsoft Office, Outlook, Internet search).
- Basic knowledge of medical terminology and familiarity with topics such as specific disease and lifestyle topics and related resources.
- Can work independently, prioritize work, meet deadlines, and achieve operational standards.
- Ability to research and problem-solve in a creative manner.
- Ability to identify when it is appropriate to refer to others.
- Knowledge of health-related topics and a general understanding of clinical services programs such as Utilization Management, Care Management and Disease Management. This is typically demonstrated by at least 2 years of successful Care Advocate experience and ability to handle a wide range of member issues or interventions.
- Proven ability to actively engage and motivate others to take action regarding their health.
- Proven ability to work in a team environment and actively participate in team success.
- Ability to understand clinical documentation such as hospital discharge plans or clinical progress notes to make appropriate care management referrals.
- Demonstrated ability to be proactive such as taking on additional projects to further develop skills.
- Work performed in home office environment, conducive to performing confidential telephonic meetings.
- May be required to work alternate work schedule or overtime.
- May be required to work outside normal schedule.
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.
If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit www.cambiahealth.com/careers/total-rewards.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
This job has expired.