Prudent Layperson-Remote

Prudent Layperson Job Description Reports to: Supervisor Company: Vision Financial Services Department: EnrollPlus Title: Prudent Layperson (L1) Classification: Non-Exempt Date: April 2025 Company Values: Make a Difference Help First Straight Talk Grow or Die Victor, Not Victim Position Summary: The Prudent Layperson (L1) is a non-medical individual who can make informed decisions about the healthcare of others. A Layperson is responsible for assessing the medical needs of members and determining whether they require medical attention. They will also communicate their conclusions to others along with a written description to support the decision made. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions · Review medical information provided by the member’s provider. · Evaluate the situation and symptoms of members who may have experienced a medical emergency · Decide whether the member should have been seen in the emergency room based on the Prudent Layperson standard · Provide a written statement to support the Layperson’s decision on each case on an individual basis. · Report results to the healthcare plan for follow up with providers. · Other Responsibilities o Always adheres to the company’s values o Always adheres to the organization’s confidentiality policy and the protection of confidential information including all company policies and procedures. o Treats clients, members, patients, guests, staff, and others with care, courtesy, and respect. Competencies • Working knowledge in Microsoft Office • Ability to communicate summary information in a written format. • Interpersonal and communication skills (both verbal and written) necessary to interact with staff and clients effectively • Independent decision-making skills • Good judgement Supervisory Responsibility This position has no supervisory responsibilities. Work Environment This job operates in a professional remote environment. This role uses standard office equipment such as computers, computer phone headsets and phones. Physical Demands While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, use hands to type, handle or feel; and reach with hands and arms. Prolonged periods sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Position Type and Expected Hours of Work This is a full-time position. Evening and weekend work may be required as job duties demand and for team meetings. Travel No travel is expected for this position. Experience • Candidates cannot have any previous experience in healthcare. Preferred Education • High school diploma or GED. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Job Type: Full-time Benefits: • 401(k) matching • Dental insurance • Health insurance • Vision insurance Application Question(s): • Have you worked in a remote and/or hybrid position before? • Are you looking for full time or part time work? • How soon would you be available to start? • Are you able to perform weekend work if required? • This position pay's $18 an hour. Does that meet your requirement? • Do you have experience working with healthcare and/or healthcare members? • What is the best email address to reach you at? • Were you referred for this position? Location: • Indiana (Required) Work Location: Remote Apply tot his job Apply To this Job