LPN or RN

Pay :  From $60,000.00 + per year

Job description :

Collaborative Care LPN / RN

Green Bay, WI

Avergent is a boutique employee benefits agency. At Avergent, we are committed to unveiling transparency in healthcare and driving transformation in the health benefits landscape. We do this by delivering best-in-class benefit plan options to our clients.

As a Collaborative Care LPN / RN, you will be working with members of our health plan evaluating their member-specific care needs. Upon assessment, you will steer, coordinate, and follow up on outcomes and next steps for best care practice. Evaluation criteria include the type of illness, history, complexity, symptoms, and care path up to outreach. The Collaborative Care Nurse may be the first point of contact for members and depending on specific member case, may need an expert medical opinion, evaluation from a PCP and / or a Specialist to begin their journey.

Responsibilities of a Collaborative Care LPN / RN

Perform assessment and preliminary clinical review via phone, text, email, or virtual appointment, to determine appropriate care option(s) to offer or triage protocol for the member.

Assist members with insurance benefit and care direction to advocate for the member's interactions with their Health Plan benefit.

Liaison treatment plans in collaboration with our Direct Primary Care partners, collaborative care physicians, specialist team, and pharmacists.

Identify barriers to success in treatment plans, such as social determents, qualification for assistance programs for medications, and care.

Cross-Functional Collaboration :

• Collaborate with Clinical Team Lead to determine Short-Term and Long-Term Complexity hand-offs.
• Collaborate with client advisors, plan partners and others necessary to ensure a seamless customer experience and identify opportunities for improvements.
• Work hand-in-hand with Care Coordinators on the team to delegate and close member cases with a high standard of service excellence with clear documentation.
• Support Leadership objectives and organizational mission.

Requirements for a Collaborative Care LPN / RN

Strong emotional intelligence : Ability to be aware of, control and express one's emotions to support self personally and professionally in an ever-changing world of health care and member expectations.

Excellent Communication Skills : Strong verbal and written communication skills with the ability to effectively listen and respond with members and internal team members.

Problem-Solving Skills : Proven ability to identify gaps, analyze problems, and develop practical solutions in a fast-paced environment. Ability to look outside the box at the bigger picture. Relentlessly and resourcefully address root cause issues and solutions for members, clients, partners and the organization.

Customer Focus : A strong, genuine passion for delivering an exceptional member experience and a commitment to exceeding their expectations with a figurative hand-on-the-shoulder. Treat them as you would your child or parent.

Organizational Skills : Must be highly organized and have strong multi-tasking abilities with the capacity to manage multiple priorities and deadlines effectively.

Team Player : Ability to work productively, positively, cooperatively within cross-functional teams while being a leader in the position. See the potential in others and yourself and work to maximize that potential by believing the best, embracing skinned knees and emphasizing progress over perfection.

Attention to Detail : Keen attention to detail and accuracy in documentation and in evaluation of member needs.

Flexibility : Ability to positively adapt to process and technology enhancements while contributing your point-of-view.

Education :

High school diploma or equivalent is required

An experienced LPN with ambulatory (in-clinic) experience in a medical setting only. Must be able to multi-task and make decisions demonstrating medical expertise in a fast-paced environment.

Best suited, but not required :

Experience with medical insurance; chronic case management in an insurance setting

Experience with care navigation.

This role typically operates in an office environment with some flexibility to work from home. Flexibility in working hours may be required to accommodate member needs, including some evenings and weekends.

As a Collaborative Care LPN / RN, you will play a vital role to our membership and our organization overall. You are meant to be the member advocate, fighting for the best care for members based on their medical needs and how to best utilize their health benefits without limiting them to the care they need. We believe in 100% transparency in healthcare and driving transformation in the health benefits landscape.

Job Types : Full-time, Part-time

Benefits :

401(k)

Dental insurance

Flexible schedule

Health insurance

Life insurance

Paid time off

Vision insurance

Work Location : In person