Pay Range:$58,700.00 - $79,300.00
Please email
HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued.
Join others who value a workplace for all.We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We're dedicated to serving Rhode Islanders.Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
Why this job matters: Responsible for strengthening the level of engagement with the beneficiary, partnering on SMART goals, facilitating completion of health risk assessments telephonically and/or in person, coordinating needed services for beneficiaries with providers, caregivers and community supports, and communicating with all members of the ICT. Serve as the liaison to the Concierge (customer service) team to ensure the member understands benefits and receives timely answers to benefit related questions. Work closely with the members of the ICT to represent and coordinate the member's health preferences. Participate in transitions of care activities, ensuring the member has all the right information to support success in the next setting.
What you will do:- Engage assigned beneficiaries/members in identifying and meeting care plan goals and interventions.
- Participate as part of the interdisciplinary care team, providing insights into member/caregiver needs and preferences and ensuring the member and caregiver receive and understand information related to care plan goals and objectives.
- Perform health risk assessments with members and caregivers.
- Conduct home and community-based outreach to engage members in care plan goals and objectives. Advocate for patients by meeting patients in various settings: medical offices, specialists, hospitals and patients' homes
- Provide clients and families with factual and non-clinical information and education in understandable manner.
- Assist with collaborating on patient care plans that reflect individual patients' needs and connect patients to appropriate resources
- Assist with coordinating patient care, e.g. transportation arrangements, medical appointment reminders, referrals, and preventive care education and/or follow-up care adherence. Refer and assist clients in accessing needed resources to meet identified needs (including grant applications, medication assistance, transportation, etc.)
- Document all interactions with and on behalf of a beneficiary/member in accordance with regulatory and company policies.
- Consult with internal clinical staff as needed when assessment or gaps in care indicate increasing severity of the member's condition requiring more intense monitoring and intervention.
- Promote health management programs and provide community resources available to members; utilize engagement skills and motivational interviewing techniques to enroll members in programs.
- Maintain supportive communication with the member via the member's channel preference (phone, web, e-mail, mail); provide education, monitor and reporting compliance, identify gaps in care, and adjust the plan as needed.
- Participate in ongoing quality improvement initiatives and overall department efficiencies.
- Assist team with department initiatives and projects.
- Perform other duties as assigned.
What you need to succeed:- High school diploma
- Two to four years' experience in a health-related position
- Extensive knowledge and experience navigating the healthcare and community resource delivery systems
- Strong communication and relationship building skills and experience working with vulnerable populations
- Bilingual (Spanish/English)
- Engagement and sales skills necessary for enrolling members into health management programs
- Persuasive skills required to negotiate, develop, influence, motivate, and move others through the stages of behavior change
- Interpersonal skills in order to interact effectively with internal and external customers
- Ability to research data, identify trends and recommend appropriate actions
- Strong attention to detail
- Ability to work successfully in a matrix environment
- Demonstrated written and verbal communications skills
The extras:- Associates or bachelor's degree in social work or other healthcare related field or active licensed practical nurse, or community health worker certification.
Location:BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer.
The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.
