Job: Disease Management Care Coach-Northside-Full Time

Disease Management Care Coach-Northside-Full Time

Requisition Number: 27350

Location: NM - Albuquerque

Type of Opportunity: Regular Full-Time

FLSA Classification: Exempt

Minimum Experience: 3 years

Minimum Education: Bachelors Degree

Shift: Days

* Assesses assigned population for readiness for behavioral change
* Uses the behavioral coaching and disease management assessment instruments, screenings and tools.
* Provides coaching and education to members and providers on behavioral change
* Educates member about health conditions, symptoms, and how choices impact management of the member's disease and health.
* Successfully works within the constraints of role by recognizing when a referral to a different level of care is indicated and providing the appropriate referrals.
* Develops plan of care for population providing coaching to that will enable management of lifestyle changes to promote disease management and health.
* Monitor and document specific coaching interventions on a regular basis, using appropriate tools and methodologies.
* Provides ongoing communication with all providers and key players about members' behavioral goals.
* Acts as a liaison between providers, patients, Nurse Case Managers,, and other members of health care team.
* Develop and maintain cooperative working relationships between PMG,and PHP regarding disease management.
* Discuss, teach, and educate providers about the need for behavioral coaching in regards to disease management.
* Participate in all UM, QA, NCQA, Medicare and Medicaid regulatory activities, policies.
* Attend and present cases at clinical meetings as requested
* Performs other functions as required

Bachelor's degree in Social Work, Counseling, Health Education, Nursing or a related health care field preferred; Associate Degree with relevant experience considered. Three years of experience in medical social work, health education, counseling or coaching, or managed health care services. Ability to conduct behavioral coaching and disease management assessments utilizing established tools and criteria. Ability to assess clients for readiness for behavioral change.
Ability to communicate telephonically with members and providers. Computer knowledge and skill to include Windows, word processing and database systems.. Strong telephonic customer service skills. Computer literacy to include maintaining spreadsheets, charts, and tables of statistics in accordance with quality measures and utilization standards. Multi-cultural experience preferred. Bilingual preferred