This role is open to telework anywhere! Preference for candidates that hold compact licensures.
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.
-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.
-3+ years of clinical experience required.
-RN with current unrestricted state licensure required
-Previous coaching experience preferred.
-Managed Care experience preferred.
-Compact Licensure preferred.
Associate's degree or equivalent experience
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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