Nurse Member Advocate

Role Overview

• Works in partnership with clinical team in support of case development and management, care and treatment plans including accurate case documentation, identifying relevant medical data to be collected and providing clear, concise communication to members, internal and external partners.
• Serve as the ongoing coordinator of primary and preventative care, episodic care, expert medical opinion and other service lines
• Obtains a comprehensive health history by leading members through a systematic and dynamic intake assessment
• Resolves prescription issues related to episodic care within established protocols and turn-around times
• Maintains availability within Outlook for scheduling of member visits and all follow ups
• Utilizes the company’s proprietary database to help connect members to Teladoc Health and external physicians and completes referrals where appropriate
• Conducts member health coaching and provides treatment decision support service via printed educational materials and videos
• Uses clinical judgment in the review of complex medical issues to ensure accuracy of clinical summaries/reports and care plans
• Provides clinical support and guidance to support staff regarding case related inquiries
• Ensures adherence to established processes and compliance with privacy legislation and regulations with all parties encountered in the service delivery
• Is accountable for meeting service standards for speed of case progression, overall quality, and member satisfaction
• Support additional projects as needed.

Requirements

• 5 years recent experience in the acute care setting preferred
• Med-surg background preferred
• Quality driven with a focus on flawless customer service
• Strong clinical knowledge base
• Excellent written and verbal communication skills
• Outstanding team player & strong interpersonal skills
• Bilingual-Spanish Speaking a plus
• Strong organizational skills and the ability to multitask with ease
• Ability to work independently but recognize when escalation is warranted
• Proficiency using technology and software including Microsoft Word, Excel, Outlook
• Active Registered Nurse license; BSN preferred.

Benefits

• Flexible Vacation Policy
• 80 hours of Paid Sick, Safe, and Caregiver Leave annually
• Performance bonus