Aetna Health Coach Consultant Registered Nurse (RN) Columbia, SC in Columbia, South Carolina
Req ID: 64796BR
This is an in office position for the Columbia/Florence SC area.
The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote and influence member's decisions related to achieving and maintaining optimal health status. Requires an RN with unrestricted active license.
Fundamental Components included but are not limited to:
Assessment of Members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member's needs and benefit plan eligibility for available integrated internal and external programs/services. Utilizes assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change. Enhancement of Medical Appropriateness & Quality of Care. Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external programs. Using holistic approach consults with supervisors, Medical Directors and/or others to overcome barriers to meeting goals and objectives. Identifies and escalates quality of care issues through established channels.
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Interprets and utilizes clinical guidelines/criteria to positively impact members health Provides up-to-date healthcare information to help facilitate the member¡¦s understanding of his/her health status Helps member actively and knowledgably participate with their provider in healthcare decision-making Monitoring, Evaluation and Documentation of Care Develops and monitors established plans of care, in collaboration with the member and/or attending physician, to meet the member's goals. Utilizes internal policy and procedure in compliance with regulatory and accreditation guidelines.
Qualifications Requirements and Preferences:
3+ years of clinical experience required
RN with current unrestricted state licensure required.
Previous coaching experience preferred
Managed Care experience preferred
Nursing - Registered Nurse
Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Understanding Clinical Impacts, Leadership - Collaborating for Results, Leadership - Creating Accountability
Benefit eligibility may vary by position.
Job Function: Healthcare
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.