Senior Care Specialist-Clinical Operations (Healthcare)

Location: Work from home in the United States

Company

hirify.global provides technology-enabled business process management and healthcare services covering clinical operations, case management, member engagement, provider solutions, claims, and analytics.

What you will do

• Assess Medicare, Medicaid, and group account members by telephone.
• Create actionable, measurable care plans and track progress toward health goals.
• Use nursing judgment to coordinate care for acute situations involving APS and EMS.
• Coordinate transitions of care, safe discharge, durable medical equipment, home health, and provider appointments.
• Assess physical, environmental, and psychosocial needs while collaborating with social workers, dietitians, pharmacists, caregivers, and providers.
• Provide health coaching, education, support, and resources for chronic condition management.

Requirements

• BSN, MSN, or equivalent nursing degree.
• Active nursing licensure is required: an individual license in a non-compact state, or an active Compact license with residence in the state holding that license.
• At least three years of clinical nursing experience, including adult chronic condition care management.
• Knowledge of complex care management principles, motivational interviewing, MCG or CMS guidelines, assessment, and documentation practices.
• Spanish and English required.
• Advanced computer, Microsoft Excel, multitasking, problem-solving, and telephonic or virtual communication skills.

Culture & Benefits

• Work-from-home arrangement within the United States.
• Autonomous decision-making and troubleshooting of periodic system issues.
• Use of multiple software applications and dual computer monitors.
• Whole Person Care approach focused on improving quality of life and achieving health goals.