Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina …and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Job Title: Chronic Disease Coach

Position Details:

• MAX HOURLY PAY RATE: $34.00/HOUR W-2.
• Work Hours/Schedule: Monday thru Friday, 8:30 am - 5:00 pm (EST).
• Contract to Hire.
• Interview process: MS Teams Video Conference.
• Role will be onsite initially and then will be remote. 
• Onsite training 4-6 weeks.
• LICENSED SOCIAL WORKER IS REQUIRED (RN IS NOT REQUIRED) - Looking for a Bachelor's in social work.

Top 2-4 PREFERRED/NICE TO HAVE skill sets/qualities:

• Microsoft office skills.
• Experience with social determinants of health.
• Good customer service skills.

Duties:

• Provide support to members for disease prevention and healthy promotion. 
• Empower members to achieve optimal health and wellness by providing personalized guidance, education, and support. 
• This role collaborates with individuals to set and reach health goals, navigate the healthcare system, and make informed decisions about their well-being within the context of their health plan benefits.
• 60% Assess for needs related to a member’s chronic condition, clinical risk and readiness for change via company needs questionnaire.  Based on the needs assessment, complete and coordinate action plans in cooperation with members, then implement plans to include member goals. Provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to elicit behavior change and increase member program engagement.
• 20% Participates in patient education with members and providers regarding the member’s condition and available benefit plans. Serves as member advocate through continued communication and education. Promotes enrollment in health and chronic condition management programs.
• 10% Provides appropriate communications (written, telephone) regarding member conditions to both health care providers and members.
• 5% Participates in data collection/input into system for clinical information flow. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
• 5% Maintains current knowledge of network status of all service providers to educate members on care they may receive related to their chronic condition(s). Assists members with referrals to appropriate internal support areas to ensure proper processing of authorized or unauthorized services, as needed.
• Work environment: Typical office environment. Employee may work form one's/out of one's home. May involve some travel within one's community.

Required skills and abilities: 

• Required Education: Associate's degree in job related field.
• Degree Equivalency: Graduate of Accredited School of Nursing or graduate of a health-related degree or 2 years job related work experience.
• Required work experience: 3 years of professional health and wellness experience.
• Licenses and Certifications: Within 4 years of hire, must get certification in health coaching (ex: National Board-Certified Health and Wellness Coach).
• Working knowledge of word processing software. 
• Knowledge of quality improvement processes and demonstrated ability with these activities. 
• Knowledge of contract language and application. 
• Ability to work independently, prioritize effectively, and make sound decisions. 
• Good judgment skills.
• Demonstrated customer service, organizational, and presentation skills. 
• Demonstrated proficiency in spelling, punctuation, and grammar skills. 
• Demonstrated oral and written communication skills. Ability to persuade, negotiate, or influence others. 
• Analytical or critical thinking skills. 
• Ability to handle confidential or sensitive information with discretion.
• Software and other tools: Microsoft Office.

Preferred Skills and Abilities: 

• Working knowledge of spreadsheet, database software. Thorough knowledge/understanding of claims/coding analysis, requirements, and processes.
• Preferred Education: Bachelor’s degree in health-related field (e.g. Nursing, Social Work, Health Ed, Wellness, Health Promotion, Behavioral Health).
• Preferred Work experience: 5 years - healthcare management.
• Preferred Specialized Training: Health Coaching Certification.

Pay Transparency:

• This is the pay range that Magnit reasonably expects to pay someone for this position is $28.00/hour - $34.00/hour. 
• Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met).

BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. 

Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty. If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!