Care Specialist/Health & Wellness Advisor Level I

Pay - $28/hr - $30/hr
Shift - 9 AM - 5 PM Hybrid

Summary
Under the direction of the Director of Care Management (PIC) and direct supervision by the Manager of Care Management, the Health & Wellness Advisor I ensures the promotion of health and wellness among HIV-positive members and other members at high-risk for HIV by conducting high-volume outreach to assess their health and psychosocial needs and support them to stay in care and adherent to medication. The Health & Wellness Advisor I works in conjunction with the PIC Clinical Care Manager and other colleagues in a team-oriented approach with a focus on establishing member rapport.

Product of Role & Responsibilities:
Performs telephonic care management activities including assessment, plan of care development, care coordination, out-patient follow-up, and ancillary service review to ensure optimum health outcomes.
Develops and implements an individualized, member-centered Plan of Care through direct telephonic member engagement, and inclusion, where appropriate, of collateral contacts including family members (with appropriate consent of the member), primary care provider, and other community and case managers to identify and address the needs and barriers of members living with HIV (and others in the Special Needs Plan) to promote the health and wellness of the member.
Promotes access to and oversees the coordination and delivery of comprehensive, quality healthcare services for members who are living with HIV, transgender, and homeless.
Provides health education using coaching and motivational interviewing techniques to promote improved health outcomes for HIV engagement in care and viral load suppression, engagement with behavioral health and substance use services and effective management of other co-morbid illnesses, such as hepatitis C, diabetes, hypertension, and asthma/COPD.
Participates in special outreach and quality improvement projects as assigned.
Documents all care management activities for each member and ensures that such documentation is in compliance with professional standards and regulatory guidelines using the correct templates.
Addresses member primary care provider assignment during outreach and reassigns members as appropriate.
Carefully follows designated departmental compliance, care management, and quality improvement and workflows as assigned.
Escalates cases and issues to their supervisor as appropriate.
Answers calls on the in-bound Automatic Call Distribution line in a professional and timely manner.
Attends and prepares for viral load suppression meetings and case conferences (interdepartmental and with facilities)
Familiarizes members to and the Product of services the plan provides as needed.
Ensures that coordination of membership enrolled in all lines of business is compliant with Federal, State, and City regulations, and are consistent with the Mission, Vision, and Values of the organization.

• High School Diploma or GED required null

Salary : $28 - $30