Not Authorized
You are currently not authorized to access this section.
Please contact your Administrator to change your authorization settings.
Please contact your Administrator to change your authorization settings.
Case Management, Associate, Care Guide
Williston, VT
Job Description
Case Management, Associate, Care Guide
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America Req #1031
Friday, February 25, 2022
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Status: Full-time, Non-Exempt
The Care Guide (CG) will work directly with members, members' families and/or advocates to ensure the member has access to MVP resources that support, promote, and facilitate engagement in the UVM Medicare Advantage Program ("UVM Health Advantage") and its benefit offerings. The CG will work as a bridge between the customer, the health plan, and the provider organization to create a seamless and positive experience to fulfill their unmet care needs. The CG will build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, informal counseling, social supports, and advocacy. The CG is responsible to address the needs and wishes of the member and his or her family and/or advocate and to support changes as they affect the member's desired outcomes, quality of care and quality of life. The CG will empower the member to make informed decisions and advocate on their behalf when deemed necessary.
The CG will collaborate with a broader team, including but not limited to Plan Guides and Care Management. In particular, the CG will support the MVP and/or The University of Vermont Health Network ("UVMHN") Care Management team by assisting members in reducing/resolving challenges or barriers so that the member may achieve their optimal level of health, independence, safety, and well-being. In this role, the CG will communicate with the member to promote member engagement, utilization of Plan benefits to enhance their health and access while supporting overall satisfaction. The CG will rely upon colleagues within the Plan designated as part of the Member's team, including Plan Guides ,Provider Guides, MVP Case Management, UVMHN Case Management, MVP Customer Care, MVP Wellness and UVMHN Wellness. A collaborative, efficient and seamless work effort is the goal of the Member's team to ensure all needs are met.
Responsibilities:
This position may be worked as a virtual (work from home) position from a Vermont or New York residence.
POSITION QUALIFICATIONS
Minimum Education
Associate's Degree in a health or human services field.
Bachelor's Degree in a Health or Human Service field preferred.
Minimum Experience
Two years of experience working within managed care/ health services environment required.
Five years of experience as a service coordinator with any population preferred. E xperience in managed care and/or working relationships with Medicare, Medicaid, or Social Service Agencies a plus.
Required Skills:
Preferred Skills
#LI-CV1
#LI-REMOTE
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
Apply Now
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America Req #1031
Friday, February 25, 2022
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Status: Full-time, Non-Exempt
The Care Guide (CG) will work directly with members, members' families and/or advocates to ensure the member has access to MVP resources that support, promote, and facilitate engagement in the UVM Medicare Advantage Program ("UVM Health Advantage") and its benefit offerings. The CG will work as a bridge between the customer, the health plan, and the provider organization to create a seamless and positive experience to fulfill their unmet care needs. The CG will build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, informal counseling, social supports, and advocacy. The CG is responsible to address the needs and wishes of the member and his or her family and/or advocate and to support changes as they affect the member's desired outcomes, quality of care and quality of life. The CG will empower the member to make informed decisions and advocate on their behalf when deemed necessary.
The CG will collaborate with a broader team, including but not limited to Plan Guides and Care Management. In particular, the CG will support the MVP and/or The University of Vermont Health Network ("UVMHN") Care Management team by assisting members in reducing/resolving challenges or barriers so that the member may achieve their optimal level of health, independence, safety, and well-being. In this role, the CG will communicate with the member to promote member engagement, utilization of Plan benefits to enhance their health and access while supporting overall satisfaction. The CG will rely upon colleagues within the Plan designated as part of the Member's team, including Plan Guides ,Provider Guides, MVP Case Management, UVMHN Case Management, MVP Customer Care, MVP Wellness and UVMHN Wellness. A collaborative, efficient and seamless work effort is the goal of the Member's team to ensure all needs are met.
Responsibilities:
- Build enduring relationships with members, families, and advocates.
- Conduct new Member welcome calls.
- Orient new members to UVM Health Advantage, including specific product offerings and the services of the CG.
- Ensure complete communication feedback to/from members regarding product design and benefits, member eligibility, and other post-enrollment activities.
- Promote Member understanding of their diagnosis and treatment plan
- Assist customers' in addressing unmet needs recognizing that Members that have needs beyond their standard benefit coverages.
- Facilitate reduction of care disruption or delays in care.
- Facilitate access to services which are culturally appropriate, meet the member's stated need for service and enhance the quality-of-service delivery.
- Promote knowledge of health delivery system(s) to empower member into self-care management.
- Support patient-centric strategies to improve health and wellness in collaboration with Care Managers and others Collaborate with MVP and/or UVMHN Care Management, UVMHN Quality Management to provide performance measurements and reporting so that the impact(s) of the role are clearly understood and recognized.
- Facilitate resolution of real and perceived disruptions of care as Member enrolls in UVM Health Advantage.
- Perform other duties as assigned by management.
This position may be worked as a virtual (work from home) position from a Vermont or New York residence.
POSITION QUALIFICATIONS
Minimum Education
Associate's Degree in a health or human services field.
Bachelor's Degree in a Health or Human Service field preferred.
Minimum Experience
Two years of experience working within managed care/ health services environment required.
Five years of experience as a service coordinator with any population preferred. E xperience in managed care and/or working relationships with Medicare, Medicaid, or Social Service Agencies a plus.
Required Skills:
- Ability to incorporate Evidence Based Innovation (EBI) Practices and information into day-to-day customer engagement.
- Ability to collaboratively work with team of UVMHN/MVP colleagues to assist and resolve member concerns and complaints.
- Extensive knowledge and experience with community organizations, social services, and public resources.
- Willingness to meet directly with members, their families, advocates, in office, home settings or other as warranted by member.
- Working knowledge of Medicare and Medicaid programs.
- Highly organized; capacity to work independently and able to manage multiple priorities appropriately; strong ability to do follow-up.
- Ability to communicate independently and directly with members, providers and staff with calmness, assertiveness, diplomacy and in a non-confrontational manner.
- Strong communication skills, both verbal and written.
- Proficient in computer skills
- Valid driver's license
- Ability to work independently and maintain flexibly in fast paced start up environment.
- Must have access to reliable daily transportation.
Preferred Skills
- Understanding of current health care market and products available in the community preferred.
- Bilingual communication (oral and/or written) is an asset.
#LI-CV1
#LI-REMOTE
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
- Job Family Administrative Support
- Pay Type Hourly
Apply Now
- Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America
Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Associate Degree
Required Experience
2+ years
Email this Job to Yourself or a Friend