[Hiring] Chronic Disease Coach @BlueCross BlueShield of South Carolina

Role Description

We are currently hiring for a Chronic Disease Coach (RN or Dietician) to join BlueCross BlueShield of South Carolina. In this role, you will provide support to members for disease prevention and healthy promotion. Empower members to achieve optimal health and wellness by providing personalized guidance, education, and support. This role collaborates with individuals to set and reach health goals, navigate the healthcare system, and make informed decisions about their well-being within the context of their health plan benefits.

This position is full-time (40 hours/week) Monday-Friday from 8:30am-5:00pm and will be fully remote. The candidate will be required to report on-site for their first day.

What You’ll Do:

• Assess for needs related to a member’s chronic condition, clinical risk, and readiness for change via company needs questionnaire.
• Complete and coordinate action plans in cooperation with members based on the needs assessment, then implement plans to include member goals.
• Provide member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening to elicit behavior change and increase member program engagement.
• Participate in patient education with members and providers regarding the member’s condition and available benefit plans.
• Serve as member advocate through continued communication and education.
• Promote enrollment in health and chronic condition management programs.
• Provide appropriate communications (written, telephone) regarding member conditions to both health care providers and members.
• Participate in data collection/input into the system for clinical information flow.
• Demonstrate compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
• Maintain current knowledge of network status of all service providers to educate members on care they may receive related to their chronic condition(s).
• Assist members with referrals to appropriate internal support areas to ensure proper processing of authorized or unauthorized services, as needed.

Qualifications

• Associate's in job related field
• Graduate of Accredited School of Nursing OR graduate of a health-related degree OR 2 years job related work experience
• 3 years of professional health and wellness experience

Requirements

• Working knowledge of word processing software.
• Knowledge of quality improvement processes and demonstrated ability with these activities.
• Knowledge of contract language and application.
• Ability to work independently, prioritize effectively, and make sound decisions.
• Good judgment skills.
• Demonstrated customer service, organizational, and presentation skills.
• Demonstrated proficiency in spelling, punctuation, and grammar skills.
• Demonstrated oral and written communication skills.
• Ability to persuade, negotiate, or influence others.
• Analytical or critical thinking skills.
• Ability to handle confidential or sensitive information with discretion.
• Microsoft Office
• Within 4 years of hire, must get certification in health coaching (ex: National Board Certified Health and Wellness Coach).

Benefits

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more