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Aetna Health Coach Consultant in Hartford, Connecticut

Req ID: 61517BR

Job Description

This position is open an in-office position in either Sugar Land, TX or Hartford, CT

This is a M-F position with 3 days a week 8am-4:30pm CST and 2 days as week 11:30am-8pm CST.

The Health Coach Consultant utilizes a collaborative process of assessment,

planning, implementation and evaluation, to engage, educate, and

promote/influence members decisions related to life style changes to achieve

and maintain optimal health status. Requires an RN with unrestricted active

license. -Responsible for managing patients in a telephonic educational disease

management program. This is a call center environment, majority of time is

spent speaking telephonically with members.

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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.

#LT-TS1

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.

Licenses/Certifications:

Nursing - Registered Nurse (RN)

Functional Skills:

Nursing - Disease management, Nursing - Medical-Surgical Care

Technology Experience:

Computer Operation - System and Console Operations, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word

Required Skills:

Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts, Leadership - Driving Change

Desired Skills:

General Business - Turning Data into Information, Leadership - Collaborating for Results

Additional Job Information:

Typical office working environment with productivity and quality expectations Work requires the ability to perform telephonic assessments and documentation during the assessment call. Work requires sitting for extended periods, performing assessments, making outbound calls to introduce our program and being available to take calls from the queue. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written.

Aetna is about more

than just doing a job. This is our opportunity to re-shape healthcare for

America and across the globe. We are developing solutions to improve the

quality and affordability of healthcare. What we do will benefit generations to

come. We care about each other, our customers and our communities. We are

inspired to make a difference, and we are committed to integrity and

excellence. Together we will empower people to live healthier lives. Aetna is

an equal opportunity & affirmative action employer. All qualified

applicants will receive consideration for employment regardless of personal

characteristics or status. We take affirmative action to recruit, select and

develop women, people of color, veterans and individuals with disabilities. We

are a company built on excellence. We have a culture that values growth,

achievement and diversity and a workplace where your voice can be heard.

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this 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.

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