LafayetteRecruiter Since 2001
the smart solution for Lafayette jobs

Patient Care Advocate (LPN, SW or MA Preferred)

Company: WellCare
Location: Lafayette
Posted on: December 6, 2019

Job Description:

WellCarehas an immediate opportunity for a Patient Care Advocate to join our Louisianateam! In this role you will work withmembers and providers to close care gaps, ensure barriers to care are removed,and improve the overall member and provider experience through outreach andface-to-face interaction with members and providers at large IPA and/or grouppractices. You will also serve tocollaborate with providers in the field, to improve HEDIS measures and provideseducation for HEDIS measures and coding. Our ideal candidate is someone with experience in healthcare orinsurance who has 2 years of experience in direct patient care, social work,quality improvement or health coaching preferably in a managed careenvironment. At WellCare, we empower youto manage the relationship and provide the resources to be successful. This position offers a robust benefitspackage including over 3 weeks of paid time off, 8 holidays and 2 floatingholidays and much more! Reports to: Sr., Manager, Quality ImprovementDepartment: Health ServicesLocation: Lafayette, LA 70506
Essential Functions:

  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Acts as the face of WellCare in the provider community with the provider and office staff where their services are embedded.
  • Advises and educates Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements.
  • Assesses provider performance data to identify and strategizes opportunities for provider improvement.
  • Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment, Operations (claims and encounters).
  • Schedules doctor appointments for members with care gaps to access needed preventive care services and close gaps in care in the provider?s office.
  • Conducts face-to-face education with the member and their family, in the provider?s office, about care gaps identified, and barriers to care.
  • Conducts telephonic outreach and health coaching to members to support quality improvement, regulatory and contractual requirements.
  • Arranges transportation for members as needed.
  • Arranges follow-up appointments for member as needed.
  • Documents all actions taken regarding contact related to member.
  • Interacts with other departments including customer service to resolve member issues.
  • Refers to case or disease management as appropriate.
  • Completes special assignments and projects instrumental to the function of the department.
  • Performs other duties as assigned. Additional Responsibilities:
    • Position may be located in a provider's office Candidate Education:
      • Required A Bachelor's Degree in Healthcare, Public Health, Nursing, psychology, Social Work, Health Administration, or related health field or equivalent work experience (a total of 4 years of experience required for the position); Work experience should be in direct patient care, social work, quality improvement or health coaching preferably in a managed care environment. Candidate Experience:
        • Required 2 years of experience in Work experience should be in direct patient care, social work, quality improvement or health coaching preferably in a managed care environment Candidate Skills:
          • Intermediate Demonstrated interpersonal/verbal communication skills
          • Intermediate Demonstrated written communication skills
          • Intermediate Ability to create, review and interpret treatment plans
          • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
          • Intermediate Ability to multi-task
          • Intermediate Ability to work in a fast paced environment with changing priorities
          • Intermediate Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
          • Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
          • Intermediate Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
          • Intermediate Demonstrated organizational skills
          • Intermediate Ability to work independently
          • Intermediate Knowledge of healthcare delivery
          • Intermediate Other Appreciation and sensitivity towards cultural diversity and targeted populations Licenses and Certifications:
            A license in one of the following is required:
            • Preferred Licensed Practical Nurse (LPN)
            • Preferred Licensed Master Social Work (LMSW)
            • Preferred Certified Social Worker (C-SW)
            • Preferred Licensed Social Worker (LSW)
            • Preferred Licensed Registered Nurse (RN) Technical Skills:
              • Required Intermediate Microsoft Word Proficient in Microsoft Office such as Word, Excel and Outlook
              • Required Intermediate Microsoft Excel Ability to use and navigate health service management systems
              • Required Intermediate Microsoft Outlook
              • Required Intermediate Healthcare Management Systems (Generic) Languages:
                • Preferred Spanish About usHeadquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

Keywords: WellCare, Lafayette , Patient Care Advocate (LPN, SW or MA Preferred), Other , Lafayette, Louisiana

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


CDL A Flatbed Trucking Job - $5,000 Sign-On Bonus
Description: 22 Years of providing the Highest Quality Driving Jobs Our drivers are our 1 Asset and their job satisfaction is our top concern At Loudon County Trucking you will experience much more. You will be (more...)
Company: P & S Transportation
Location: Baton Rouge
Posted on: 12/7/2019

Claims Research Specialist II
Description: Claims Research Specialist II Position Purpose: Assist in reviewing investigating, adjusting and resolving complex claims, claims appeals, inquiries, and inaccuracies in payment of claims. Also, responsible
Company: Centene
Location: Baton Rouge
Posted on: 12/7/2019

Claims Liaison II
Description: Description: Position Purpose: Serve as the claims payment expert for the Plan and as a liaison between the plan, claims, and various departments to effectively identify and resolve claims issues. Act (more...)
Company: Centene Coproration
Location: Baton Rouge
Posted on: 12/7/2019


Flooring Installers Wanted
Description: Job Details Company Overview Flooring Installers Wanted Empire Today, LLC is experiencing tremendous growth and is seeking qualified and experienced independent contractor installers. If you install Carpet, (more...)
Company: Empire - Today
Location: Baton Rouge
Posted on: 12/7/2019

Brand Ambassador
Description: We are looking to hire enthusiastic Brand Ambassadors to be the face and voice of our brand. As a successful candidate, you will be involved in increasing brand awareness and sales by promoting our remodeling (more...)
Company: Re-Bath Louisiana Company Store
Location: Baton Rouge
Posted on: 12/7/2019

Grants Administrator
Description: Overview Are you ready to join an organization where you can make an extraordinary impact every day Imagine all Americans enjoying ideal cardiovascular health free of heart disease and stroke. At the (more...)
Company: American Heart Association
Location: Baton Rouge
Posted on: 12/7/2019

Class A Flatbed Truck Driver
Description: 22 Years of providing the Highest Quality Driving Jobs Our drivers are our 1 Asset and their job satisfaction is our top concern At Loudon County Trucking you will experience much more. You will be (more...)
Company: P & S Transportation
Location: Baton Rouge
Posted on: 12/7/2019

Credentialing Rep
Description: The Credentialing Rep processes credentialing and recredentialing applications including privileging of health care providers. Reviews applications, prepares verification letters and maintains MSOW database. (more...)
Company: Franciscan Missionaries of Our Lady Health System
Location: Baton Rouge
Posted on: 12/7/2019

Vice Provost Dean of the Graduate School
Description: Date Posted November 17, 2019 Category Executive-Dean-Education Employment Type Full-time Application Deadline Open until filled Louisiana State University invites applications for the position of Vice (more...)
Company: Louisiana State University
Location: Baton Rouge
Posted on: 12/7/2019

Travel Medical Lab Tech - $1,531 per week
Description: NurseFly Travel Nursing with Cross Country Allied is seeking a travel medical lab tech for a travel job in Baton Rouge, Louisiana:- Specialty: Medical Lab Tech- Discipline: Allied Health Professional- (more...)
Company: NurseFly Travel Nursing
Location: Baton Rouge
Posted on: 12/7/2019

Log In or Create An Account

Get the latest Louisiana jobs by following @recnetLA on Twitter!

Lafayette RSS job feeds