Bilingual Health Guide – Remote

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Bilingual Health Guide – Remote
Job Description Summary
Provides ongoing, community-based support for an assigned caseload of health plan enrollees to improve access to care and care coordination. Establishes a relationship with the enrollee, the care coordination team, and providers. Conducts new enrollee outreach and orientation, arranges appointments and transportation as needed. Assists the enrollee in learning to navigate the health care delivery system, community resources, transportation, and effectively use health plan benefits.
Job Description

Conducts outreach and orientation for new enrollees. Gathers information needed to ensure continuity of care and permission to share information.

Administers Health and Wellness Questionnaire.

Seeks connection by working with the Peer Support Specialist and leveraging community services, care providers, family members, schools, etc.

Assists enrollees in accessing care and ensures care is received. Helps members, as needed, in selecting providers, making appointments, and planning transportation.

Contacts enrollee or provider to ensure appointments have occurred. Assists in transitions of care to and from alternative levels of care or settings.

Makes follow up care arrangements and ensures post-hospital care is delivered as planned.

Meets with enrollee regularly (as determined by individual risks) in order to monitor progress according to the Care Coordination Plan.

Reminds enrollee of self-management tools and crisis support. Informs and engages the Care Coordination Team if enrollee has difficulty adhering to the care coordination plan or adhering to treatment and needs additional support.

Works with enrollee and family/supports to engage in socialization, work or volunteer related activities, or access community resources and services.

Maintains up to date documentation in the Care Coordination Plan and other Health Services tools.

Prepares information for Care Coordination Team meetings and as requested, for shared treatment planning sessions.

Responsibilities
Managed care experience preferred.
Experience documenting in a clinical record or information system.
Experience in community service, health care or social services and/or community-based or home health care experience preferred
Work Experience
Work Experience – Required: Customer Service
Work Experience – Preferred: Managed Healthcare
Education
Education – Required:
Education – Preferred: Associates, Bachelors
Certifications
Certifications – Required:
Certifications – Preferred:
To review our Benefits, Incentives and Additional Compensation, visit our and click on the “Benefits at a glance” button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics