Care Coordination (RN) – REMOTE, Compact TX

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Evry Health is seeking a tech-savvy Nurse to join our team 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 reside in the United States and in the Eastern or Central time zone. About Evry Health and Globe Life We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives. Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.

Roles and Responsibilities

    • Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
    • Use negotiation and motivational interviewing techniques to increase engagement.
    • Pro-active and reactive support for members, including outbound phone/email/text outreach.
    • Employ active 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 excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins, efficiently answering and documenting member/provider calls.
    • Accurately track and document work on a variety of internal software tools and platforms.
    • Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers.
    • Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
    • Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals.
    • Ability to interact with external facility or providers as needed to gather 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 commercial population.
    • You have 3-5 years of nursing experience in a clinical setting assisting with direct patient care, such as a hospital or ambulatory setting.
    • Must have a current, 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, and digital health programs.
    • You have an area of interest or experience within 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 Salesforce/Healthcloud/CareIQ.
    • Bonus: Experience working in a call center.
    • Bonus: Spanish fluency (conversational).

Telecommuting Requirements

    • This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.
    • Company business hours are weekdays 9-5 CST. We will only consider candidates in the United States who reside in the CST or EST time zones.
    • Required to have a dedicated work area established that is separate from other living areas and provides information privacy.
    • Ability to keep all company sensitive documents secure.
    • Must live in a location that receives an existing high-speed internet connection/service.

Benefits Package

    • Competitive salary
    • Comprehensive health, dental, and vision insurance as well as life and disability
    • Retirement savings plan with company match
    • Generous time off/vacation
    • Professional development opportunities
    • Flexible and remote work environment
Evry Health is an EEO employer - Read More Here We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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About United Kingdom

The United Kingdom is an island nation located on the northwest coast of Europe. The United Kingdom includes the entire island of Great Britain, which includes England, Wales, and Scotland, as well as the northern part of the island of Ireland. The name Great Britain is sometimes used to refer to the United Kingdom as a whole. The capital is London, which is one of the business, financial, and cultural centers of the world. Other major cities are Birmingham, Liverpool, and Manchester in England, Belfast and Londonderry in Northern Ireland, Edinburgh and Glasgow in Scotland, and Swansea and Cardiff in Wales.

Common Interview Questions

  • Tell me about yourself.
  • Walk me through your resume.
  • How did you hear about this position?
  • Why do you want to work at this company?
  • Why do you want this job?
  • Why should we hire you?
  • What can you bring to the company?
  • What are your greatest strengths?
  • What do you consider to be your weaknesses?
  • What is your greatest professional achievement?
  • Tell me about a challenge or conflict you’ve faced at work, and how you dealt with it.
  • Tell me about a time you demonstrated leadership skills.
  • What’s a time you disagreed with a decision that was made at work?
  • Tell me about a time you made a mistake.
  • Tell me about a time you failed.
  • Why are you leaving your current job?
  • Why were you fired?
  • Why was there a gap in your employment?
  • Can you explain why you changed career paths?
  • What’s your current salary?
  • What do you like least about your job?
  • What are you looking for in a new position?
  • What type of work environment do you prefer?
  • What’s your work style?
  • What’s your management style?
  • How would your boss and coworkers describe you?
  • How do you deal with pressure or stressful situations?
  • What do you like to do outside of work?
  • Are you planning on having children?
  • How do you stay organized?
  • How do you prioritize your work?
  • What are you passionate about?
  • What motivates you?
  • What are your pet peeves?
  • How do you like to be managed?
  • Do you consider yourself successful?
  • Where do you see yourself in five years?
  • How do you plan to achieve your career goals?
  • What are your career aspirations?
  • What’s your dream job?
  • What other companies are you interviewing with?
  • What makes you unique?
  • What should I know that’s not on your resume?
  • What would your first few months look like in this role?
  • What are your salary expectations?
  • What do you think we could do better or differently?
  • When can you start?
  • Are you willing to relocate?
  • How many tennis balls can you fit into a limousine?
  • If you were an animal, which one would you want to be?
  • Sell me this pen.
  • Is there anything else you’d like us to know?
  • Do you have any questions for us?

Educational Qualification

Candidates Who Have Passed Graduate or its Equivalent from a Recognized Board or University Are Eligible For this recruitment. Kindly check the Official Notification for more qualification details. Notification Link Is Given Below.

Document Required

Required Documents for This recruitment: Candidate should have these documents before applying online. Candidates are suggested to read the official notification before applying.

  • Qualification certificate with mark sheets.
  • Passport size photographs.
  • Signature.

How to Apply

All the eligible candidates can apply for this job as mentioned below:

  • Read official notification carefully from the official website.
  • Read notification carefully before applying.
  • Fill the application form (link is given below).
  • Attach required documents and passport size photo with signature.
  • Then submit. Done.