Retail Center Navigator RN (Hialeah, FL) GuideWell - Hialeah, FL
Posted on: November 14, 2021
Love engaging with people to help them achieve better health? Come
join the exciting, rapidly expanding Direct-to-Consumer team. We
make it our priority to utilize our skills and knowledge to help
members make positive changes in their health and well-being. While
on this team you will proactively manage prospective customers and
members' experience through the health care continuum and delivery
system in a Florida Blue Center environment by assessing needs,
educating on benefit plans, costs, choices, tools and programs and
referring to Florida Blue programs and resources as appropriate.
Contacts and referrals can come from a variety of internal and
external sources, including member self-service, Care Managers, the
member contact center, third party vendors such as Health Dialog,
wellness/health fairs and GuideWell Enterprise Channels. Present
health education classes and programs to members and non-members.
Perform Personal Health Assessments on members and provide
education on ways to achieve better health.
- The essential functions listed represent the major duties of
this role, additional duties may be assigned.
- Provides personal, Care engagement and assistance with
coordination of health care benefits and services to prospective
customers and members in the Direct-to-Consumer Channel by:
- Performing Personal Health Assessments and providing education
on the biometric results
- Closing member care gaps by accurately documenting test results
in the clinical record
- Presenting health education classes and programs
- Performing prospective customer and member needs assessment in
order to provide the most effective and efficient customer
- Collaborating with various teams to improve the Enterprise
STARS rating through targeted member campaigns.
- Participating in outbound call campaigns to members for
Enterprise Partners, including Commercial, U65, and Medicare
- Facilitating benefit savings for members by proactively
educating them on benefit plan impacts and choices.
- Facilitating problem solving and issue resolution; e.g. assists
with access to care issues.
- Providing referrals to community resources such as elder
- Educating prospective customers and members on benefits
structure and care setting alternatives.
- Educating prospective customers and members and helping them
access and understand cost and quality comparisons.
- Providing appropriate referrals to other corporate programs
such as, Healthy Addition, New Directions and Care
- Coordinating care for members as appropriate using a
personalized care plan.
- Host Customer Video Appointments.
- Educate members on digital platforms such as Blue for Me and
- Performs other duties as assigned. (100%)
- **This is an onsite position at our Hialeah location**
Required Work Experience
1+ years related work experience. Experience Details: Nursing
Diploma, ASN, BSN Degree
High school diploma or GED
Required Licenses and Certifications
RN - Registered Nurse - State Licensure And/Or Compact State
Licensure Active Florida RN license Upon Hire
BCLS - Basic Life Support CPR Certification Upon Hire
Health Coaching Certification 180 Days
Additional Required Qualifications
Knowledge and understanding of benefit plans
Knowledge of healthcare continuum
Experience with automated medical systems
Health Coaching Certification within 6 months after hire that will
remain current during employment
Additional Preferred Qualifications
--- 3 or more years' managed care, case management, disease
managements, clinical nursing, home health care or related
experience with hands-on patient interaction --- Sales work
experience --- Knowledge of benefit plans --- Knowledge of provider
contracting and reimbursement methodologies --- Knowledge of member
tools such as the Member Portal --- Knowledge of care management,
disease management and similar care programs --- Knowledge of
health and specialty products and ability to inform others of how
to use benefits in conjunction with specific illnesses ---
Knowledge of community resources
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to
move objects. Jobs are sedentary if traversing activities are
required only occasionally.
Florida Blue is a federal contractor. In accordance with the
President's Executive Order on Ensuring Adequate COVID Safety
Protocols for Federal Contractors, all Florida Blue employees are
required to be fully vaccinated against COVID-19 as a condition of
employment, unless an employee qualifies for an accommodation for
religious or medical reasons. This requirement applies regardless
of work location.
We are an Equal Opportunity/Protected Veteran/Disabled Employer
committed to creating a diverse, inclusive and equitable culture
for our employees and communities.
Keywords: GuideWell, Hialeah , Retail Center Navigator RN (Hialeah, FL) GuideWell - Hialeah, FL, Healthcare , Hialeah, Florida
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