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 working in a team-based environment
Knowledge of Medicare and health services and benefits

Hourly wage pending experience

Hours: Monday through Friday 7AM to 8PM Central Time

This is a fully remote work at home role. You must have a secure, private wok at home area with a hardwired internet connection with speeds greater than 5MB upload and 10MB download.

Sagility Offers Competitive Benefits Including:     