LVN/LPN Care Specialist - Clinical Ops

Job Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Sagility has more than 25,000 employees across 5 countries.

Job title:

LVN/LPN Care Specialist - Clinical Ops

Job Description:

We are currently hiring a talented LPN/LVN, Health Engagement Coach.? This role will be responsible for 1:1 education on chronic conditions, Health and Wellness, and Lifestyle Management Programs.

The LPN/LVN Engagement coach has a key role in ensuring the member will maintain a healthy lifestyle while in the community.

Successful candidates must hold a valid, current license issued by the state in which the candidate resides.

Key responsibilities:???


* Establish health improvement plans based on member specifications


* Establish personalized goals


* Support customers in achieving those goals through behavior changes to improve health status


* Work with customers to reduce health risks and improve quality of life


* Communicates results of reviews verbally, in the medical record, and through official written notification to the primary care team, specialty providers, care managers, vendors and members in adherence with regulatory and contractual requirements


* Provides decision-making guidance to clinical teams on service planning as needed


* Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in accordance with Standard Operating Procedures


* Ensures accurate documentation of clinical decisions and works with Manager to ensure consistency in applying policy


* Works with Manager and other clinical leadership to ensure that departmental and organizational policies and procedures as well as regulatory and contractual requirements are met


* Additional duties as requested by supervisor


* Maintains knowledge of CMS and State regulatory requirements

Education Requirements:


* Associate?s degree required,


* LPN/LVN- you must hold a valid, current license issued by the state in which the candidate resides

Desired Experience (nice to have):


* Customer experience


* Remote work experience


* Proficient with Microsoft Teams and Office.

Required Knowledge, Skills & Abilities (must have):


* Ability to complete assigned work in a timely and accurate manner


* Ability to work independently

Desired Knowledge, Skills, Abilities & Language (nice to have):


* Flexibility and understanding of individualized care plans


* Ability to influence decision making


* Strong collaboration and negotiation skills


* Strong interpersonal, verbal, and written communication skills


* Comfort workin...