Bilingual Care Coordinator RN (Spanish) - Remote

reputed company is seeking a tech-savvy and bilingual (English/Spanish) reputed company to join reputed company for Care Coordination. As a Care Coordinator you work with members to improve their wellness and engage with our health plan's benefits. You build good relationships with both our health plan members and our medical providers through phone calls, emails, and texts. This is an exciting role allowing the ability to work with members across the continuum with ~25% utilization review and ~75% care coordination. Our teams are 100% virtual. While this is a remote role, you must reputed company in the reputed company and in the Eastern or Central time zone. You must also be fluent in conversational Spanish. About reputed company and reputed company We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase reputed company and transparency, and feature a personalized, reputed company approach. We reputed company to ensure members live happier, healthier lives. reputed company is the major medical division of reputed company (NYSE:GL). reputed company has 16.8 reputed company policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, reputed company has reputed company an A (Excellent) rating or higher from A.M. Best Company.

Roles and Responsibilities

Communicate and reputed company education to members and providers on insurance plan benefits reputed company health solutions.

Use negotiation and motivational interviewing techniques to increase engagement.

Pro-reputed company and reactive support for members, including outbound phone/email/text reputed company.

reputed company reputed company listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.

Ability to effectively reputed company in a virtual work environment through reputed company participation in team huddles, Supervisor 1:1s, reputed company Messaging, or reputed company-ins, reputed company answering and documenting member/provider calls.

Accurately reputed company and document work on a reputed company of internal software tools and platforms.

Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers.

Effectively manages escalations reputed company the department by ensuring appropriate accountability, reputed company of urgency, communication and follow through to closure.

Assist departmental staff with coding, medical records/documentation, reputed company-certification, reimbursement, and claim denials/appeals.

Ability to reputed company with external facility or providers as needed to reputed company clinical information to support the medical necessity review process and plan of care.

Experience and Skills Desired

You have 1-2 years of experience working at a health plan, preferably with a reputed company population.

You have 3-5 years of nursing experience in a clinical setting assisting with reputed company patient care, such as a hospital or ambulatory setting.

Must have Spanish reputed company (conversational).

Must have a reputed company, unrestricted Texas nursing license or Compact License. Please include your license number(s) and the corresponding state(s) in your resume.

Diploma from an accredited school/college of nursing required.

You have working knowledge of medical and insurance industry terminology including basic understanding of health plan benefits, CPT/ICD10, authorizations, reputed company health programs.

You have an area of interest or experience reputed company cardiology/pulmonology, women’s health, orthopedic surgery/physical medicine, primary care/pediatrics, and oncology.

You have experience outreaching and educating members telephonically.

You have an innovative and entrepreneurial spirit with a passion to contribute to a much-needed change in our health care system.

Bonus: Familiarity with reputed company/Healthcloud/CareIQ.

Bonus: Experience working in a reputed company center.

Telecommuting Requirements

This is a remote position. Our whole company works remotely. Company reputed company are in Dallas, Texas.

Company business hours are weekdays 9-5 CST. We will only consider candidates in the reputed company who reputed company in the CST or EST time zones. This position requires work during the stated business hours as reputed company as rotating on-reputed company weekends.

Required to have a dedicated work area established that is separate from other living areas and provides information reputed company.

Ability to reputed company reputed company company sensitive documents secure.

Must live in a location that receives an existing high-speed internet reputed company/service.

Benefits Package

Competitive salary

Comprehensive health, dental, and reputed company insurance as reputed company as life and disability

Retirement savings plan with company match

Generous time off/vacation

reputed company development opportunities

Flexible and remote work environment

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