Health Guide - Baton Rouge Louisiana

Company: Prime Therapeutics
Location: Baton Rouge, Louisiana
Posted On: 05/07/2024

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. More...

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