The Disease Management Specialist may include one or two areas of focus in support of disease management education and resource health information services to beneficiaries experiencing lifestyle changes, personal stress, anxiety and/or depression. This includes providing initial screening for appropriateness and type of information, whether local or national resources, while working on the telephone to empower the beneficiary to better self manage the disease and communication with their provider.
Essential Duties & Responsibilities
Outbound Education:One-on-one and group based disease management education by telephone. Initial and post-intervention patient assessment.Program planning and update meetings.Inbound Resource Line Education:One-on-one and group heath resource information.Conducts brief needs assessment to assist the beneficiary and identify resources needed to assist with the appropriate condition presented by the beneficiary and/or group.Cross-functional responsibilities:Maintains current information on available resources including programs available, cost, and resource contact information.Conducts individual needs assessments and provides related resource information to beneficiaries.Conducts brief post intervention follow-up calls.Develops and maintains policies and procedures.Mediates calls to next level within the organization of patient/beneficiary service delivery appropriateness.Obtains continuing education/training as required by supervisor.
Degree or related education for disease specialty
Certification and/or License requirement varies based on area of disease management specialty. Candidate may have one of the following: Licensed Clinical Social Worker (LCSW), Respiratory Therapist, Diabetes Educator, Marriage and Family Therapist or Registered Nurse (RN), and preference that candidate is working toward a Clinical License within application of specified area is highly desirable.
Government Clearance & US Citizenship Requirement
Minimum two years experience with disease-specific education, either outbound or resource line serviceORAny combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
Knowledge, Skills & Abilities
Demonstrated knowledge of disease process and its management, including resource line knowledgeAbility to motivate patients to change through knowledge and ownership of self-empowermentStrong organizational and time management skillsOutstanding written and verbal communication skillsExcellent customer service skillsProficiency in Word, Lotus (notes), and Access
- The following section describes the general physical requirements for this position. Please note that constant refers to more than 81% of time; significant refers to 40-80%; and moderate refers to 20-40% of the time.
- Operates personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment.
- Exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations.
- May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays).
- May be required to maintain established work pace, meet deadlines; may have last minute urgent requests.
- Physical activity may include: twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc.
- Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned.
- Required to have hearing ability to receive detailed information through oral communication.
- Required to have speaking ability to express or exchange ideas.
- Constant concentration may be required on various subjects by listening, reading and thinking clearly.
- Interaction with others may be required. May need to listen, think, and speak in order to interact with others. Business interactions and behavior between coworkers and/or external customers are required. This may require face-to-face or telephone interactions.
- Thinking at work may include listening, learning, analyzing, evaluating, and the ability to interpret what is seen and/or heard, or to link information from one issue to the next.
- Constant computer usage including typing and/or eye strain.
- Constant repetitive arm, wrist, hand and finger motions -- making repetitive movements (e.g. key boarding, filing, data entry).
- Constant phone usage; headsets may be required.
- Constant amount of time spent working in a loud office environment with frequent interruptions/distractions.
- Constant sedentary work (desk bound or seated).
- Constant reading is required via computer screen and/or bound printed materials.
DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills required of personnel so classified.
Health Net, Inc. supports a drug-free work environment and requires
pre-employment background and drug screening.
Health Net and its subsidiaries are an Equal Opportunity/Affirmative Action
Employer - Minorities/Females/Veterans/Disability
About Health Net, Inc.
Health Net, Inc. (Health Net) is an integrated managed care organization that delivers managed healthcare services through health plans and government-sponsored, managed-care plans. The Company operates and conducts its businesses through its subsidiaries. Health Net's health plans and government contracts subsidiaries provide health benefits through its health maintenance organizations (HMOs), insured preferred provider organizations (PPOs) and point-of-service (POS) plans to approximately 6.7 million individuals across the country through group, individual, Medicare, (including the Medicare prescription drug benefit commonly referred to as Part D), Medicaid, TRICARE and Veterans Affairs programs. The Company operates within two segments: Health Plan Services and Government Contracts.