Bilingual Care Coordination, RN

Job not on LinkedIn

2 days ago

🤠 Texas – Remote

Although this job is listed in Texas, this company may be open to hiring remote in other states.

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Evry Health

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Healthcare Insurance • B2B • Wellness

Evry Health is a modern, mobile-first health insurance company that provides fully insured employer health plans and personalized care teams. Built for midsize and larger employers (primarily in Texas), Evry offers no-copay, no-deductible plans, 24/7 virtual care, integrated wellness programs, and individualized support from nurses, nutritionists, and doctors to simplify costs and improve employee health. The company emphasizes a human, member-focused approach and digital tools (iOS/Android app) to deliver care and benefits.

51 - 200 employees

Founded 2017

⚕️ Healthcare Insurance

🤝 B2B

🧘 Wellness

📋 Description

• Communicate and provide education to members and providers on insurance plan benefits and digital health solutions. • Use negotiation and motivational interviewing techniques to increase engagement. • Pro-active and reactive support for members, including outbound phone/email/text outreach. • Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement. • Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins, efficiently answering and documenting member/provider calls. • Accurately track and document work on a variety of internal software tools and platforms. • Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers. • Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. • Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals. • Ability to interact with external facility or providers as needed to gather clinical information to support the medical necessity review process and plan of care.

🎯 Requirements

• You have 1-2 years of experience working at a health plan, preferably with a commercial population. • You have 3-5 years of nursing experience in a clinical setting assisting with direct patient care, such as a hospital or ambulatory setting. • Must have Spanish fluency (conversational). • Must have a current, unrestricted Texas nursing license or Compact License. Please include your license number(s) and the corresponding state(s) in your resume. • Diploma from an accredited school/college of nursing required. • You have working knowledge of medical and insurance industry terminology including basic understanding of health plan benefits, CPT/ICD10, authorizations, and digital health programs. • You have an area of interest or experience within cardiology/pulmonology, women's health, orthopedic surgery/physical medicine, primary care/pediatrics, and oncology. • You have experience outreaching and educating members telephonically. • You have an innovative and entrepreneurial spirit with a passion to contribute to a much-needed change in our health care system. • Bonus: Familiarity with Salesforce/Healthcloud/CareIQ. • Bonus: Experience working in a call center.

🏖️ Benefits

• Competitive salary • Comprehensive health, dental, and vision insurance as well as life and disability • Retirement savings plan with company match • Generous time off/vacation • Professional development opportunities • Flexible and remote work environment