Care Specialist
from 🇺🇸 United States
Sagility combines industry-leading technology andtransformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
The Care Manager is responsible for developing a health coaching relationship with members and assisting the member through the process of actively working towards better health by providing support, encouragement, and education on chronic conditions. The Care Manager supports coordination of care and condition management activities with members, caregivers, and providers.
Essential Functions:
• Develop a trusting relationship with members to support the member through the process of changing behavior and improving management of their health by utilizing motivational interviewing techniques and change management concepts.
• Assist in coordinating members’ relationships with multiple service systems. This may include activities such as:
• Educational resources
o Recommendations for functional adaptations, durable medical equipment, and care coordination for other skilled interventions and preventive services.
• Present health education in a culturally appropriate format. For example, teaching a member how to prepare traditional foods using less fat
• Provide social support to improve members’ adherence to medical treatment plan
• Encourage the member in adoption of habits that are conducive to improved management of their chronic condition
• Develop an individualized plan including goals and plan of action
• Serve as a resource to Care Management team members
Job Requirements:
Education:
College degree in a health-related field preferred
Professional Qualification:
Certification may be required per client contract.
Current and unrestricted OTA license/certification may be required
LPN/LVN may be required
Experience:
Minimum 1-3 years’ clinical experience with patient assessments.
Experience utilizing Motivational Interviewing techniques and behavioral change theory to facilitate member adoption of positive changes and improve health.
Experience working with the Medicare population.
Functional/Technical Knowledge, Skills and Abilities Required:
With Moderate Competency Level in the ff.:
1. Excellent interpersonal skills
2. Ability to understand and interpret policy provisions.
3. Product knowledge
4. Typing Skills
5. Problem Solving Skills
6. Proficient computer skills
7. Demonstrates empathy
8. Strong organizational skills
In addition:
Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
Ability to assist member in navigating the healthcare system and community-based resources
Culturally sensitive and competent for assigned membership
Strong organizational skills; ability to multi-task and be nimble
Ability to work remotely
Ability to determine when to escalate issues appropriately and in a timely manner
Job title:
Job Description:
Essential Functions:
• Develop a trusting relationship with members to support the member through the process of changing behavior and improving management of their health by utilizing motivational interviewing techniques and change management concepts.Â
• Assist in coordinating members’ relationships with multiple service systems.  This may include activities such as:
• Educational resourcesÂ
o Recommendations for functional adaptations, durable medical equipment, and care coordination for other skilled interventions and preventive services.
• Present health education in a culturally appropriate format.  For example, teaching a member how to prepare traditional foods using less fat
• Provide social support to improve members’ adherence to medical treatment plan
• Encourage the member in adoption of habits that are conducive to improved management of their chronic condition
• Develop an individualized plan including goals and plan of action
• Serve as a resource to Care Management team members
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