About the Role
Evry Health is seeking a tech-savvy Nurse to join our team as a Care Coordinator. 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. Our care coordination teams are 100% virtual.
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.
Key Responsibilities
- Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
- Pro-active and reactive support for members, including outbound phone/email/text outreach.
- Employ active listening & motivational interviewing skills, manage calls professionally, timely, and with thorough documentation, for both members and providers.
- 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.
- Use negotiation and motivational interviewing techniques to increase engagement.
- Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals.
Qualifications
- 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.
- 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/or oncology.
- You have experience outreaching and educating members telephonically.
- Bonus: Familiarity with Salesforce/Healthcloud/CareIQ.
- Bonus: Experience working in a call center
Telecommuting Requirements
- 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 the United States.
- Must live in a location that receives an existing high-speed internet connection/service.
Location and Benefits
- This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.
- Company business hours are weekdays 9-5 CST and weekends 9-noon CST.
- Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Employment Status
- Full time salaried position with rotating weekends for utilization review cases.
Education and Licensing Requirements
- Must have a current, unrestricted Texas nursing license or a Compact License.
- Diploma from an accredited school/college of nursing required.
To Apply
- Please attach your resume when submitting through this LinkedIn posting.
- The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description. Evry Health is an EEO employer (see https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf)
