Responsible for ensuring that appropriate member treatment plans are followed on less complex cases and for proactively identifying ways to improve the health of our members and meet quality goals. Primary duties may include, but are not limited to:
Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
Assesses member compliance with medical treatment plans via telephone or through on-site visits.
Identifies barriers to plan compliance and coordinates resolutions. Identifies opportunities that impact quality goals and recommends process improvements.
Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
Coordinates identification of and referral to local, state or federally funded programs.
Coaches members on ways to reduce health risks.
Prepares reports to document case and compliance updates.
Establishes and maintains relationships with agencies identified in appropriate contract.
Requires a high school diploma
1 year of related experience; or any combination of education and experience, which would provide an equivalent background.
Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
Bilingual candidates preferred
Behavioral Health experience
Once an offer is accepted, all external applicants are subject to a background investigation
and if appropriate, drug testing. Offers of employment shall be contingent upon
passing both the background investigation and drug testing (if required).
associate referral process on WorkNet. Official guidelines for the associate referral
- Current WellPoint associates: All referrals must be submitted through the formal
program can be found in My HR.
you for bank account information when you are applying for a job.
- WARNING: Please beware of phishing scams. Our company will never ask
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