RN Clinical Care Guide (Case Management Exp) - Mesa (On-site)

Blue Cross Blue Shield of Arizona; Colorado; On-site; USD 75,000 - 95,000; Full time

Job summary

Prosano Health Solutions, in partnership with Blue Cross Blue Shield of Arizona, seeks a Clinical Care Guide (RN) to lead care navigation and patient experience on-site at the Care Center. You will coordinate referrals, support members in person and virtually, and collaborate with providers to improve health outcomes and cost savings.

This on-site role requires an AZ residency and an AZ fingerprint clearance; excellent communication and empathy are essential.

Qualifications

• RN license to practice in the state.
• BLS certification required.
• Experience with Electronic Medicare Records.
• Customer service orientation and experience.
• Strong multi-modal communication skills.
• Highly collaborative team player.
• Ability to maintain patient confidentiality.
• AZ fingerprint clearance card.

Responsibilities

• Provide end-to-end referral and diagnostic testing navigation.
• Support members in-person and virtually with real-time consultations and scheduling.
• Play a critical role in improving health outcomes and cost savings.
• Be an empathetic problem-solver and trusted partner to patients.
• Clarify and explain referrals for specialists and diagnostics.
• Lead end-to-end care processes for referrals or tests.
• Lead quality programs and patient outreach for elevated care.
• Support members with chronic conditions through education and reminders.
• Handle management and integration of office processes.
• Lead service and schedule requests on members’ behalf.
• Inform and equip Care Team with referral information and requirements.
• Build relationships with providers and community partners.
• Perform additional duties as assigned.

Skills

Interpersonal skills

RN license

BLS certification

Medicare records experience

Customer service

Communication skills

Collaborative

Empathy and advocacy

Confidentiality

AZ fingerprint clearance

Medical terminology

Education

BSN

CCM certification

Tools

Health care software platforms

Electronic health records

Job description

About Prosano Health Solutions: Prosano Health Solutions, in partnership with Blue Cross Blue Shield of Arizona, has launched an Advanced Primary Care model with a clear mission: To Inspire Health and Make it Easy. Our goal is to deliver affordable, convenient, and personalized care to the communities we serve. Our Advanced Primary Care model is focused on providing a signature patient experience which will raise the bar in both the delivery of care, and by ensuring health equity is top of mind. And, in every market we serve, we assure that a customized, high-value system of care is available for our members. Together, we will set the standard for how healthcare can and should be delivered in our State.

Why Join Our Team?

We are growing our team. The team will include people who share our passion and deep commitment to taking the primary care experience to a new level. Our team is unified in providing not only comprehensive care, but a truly exceptional patient experience, leaving our patients with the lasting impression of trust and compassion. We realize we can do great things by working together and adapting processes to provide the best possible care for people. Together, we will improve the health within our communities and make a difference in people’s lives. If you share this vision and desire to do something different...we look forward to talking to you!

Working hours include morning, night, or weekend hours. The position will require to work 100% on-site at the Care Canter location. This position is Onsite only. This Onsite work opportunity requires residency, and work to be performed, within the State of Arizona.

You Will:

• The Clinical Care Guide (RN) will be a key contributor to our first-class care team at Prosano Health Solutions. They will deliver on our commitment to excellence to our patients and help us grow through their role. The Clinical Care Guide will have end to end responsibility for our specialist and diagnostic testing navigation, as well as in leading and partnering with the care team in supporting patients in their journey toward their best health. This position has an emphasis on customer/patient care excellence, privacy, compliance, and serving in a dynamic health setting.
• Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments
• Play a critical role in the achievement of improved health outcomes and cost savings
• Be an empathetic problem-solver and become the most visible partner to all patients
• Clarify and explain referral for specialist and diagnostic service recommendations
• Care for end to end process as needed, for referral or specialist services
• Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs
• Support members with chronic conditions by providing education, reminders, and other support
• Handle the management and integration of office processes
• Lead service and schedule requests on member’s behalf
• Inform and equip Care Team with referral information and requirements
• Be an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partners
• Perform all other duties as assigned

You Have:

• Excellent interpersonal skills to include maintaining courteous, friendly and effective communications with patients, team members and external parties
• Current state license to practice as a Registered Nurse
• BLS certification
• Electronic Medicare Records experience
• Customer service orientation and experience
• Strong communication skills across multiple modalities
• Highly collaborative
• Empathy and advocacy
• Exceptional organizing skills, detail-orientation
• Must be able to maintain confidentiality at all times
• Active AZ fingerprint clearance card

Preferred Qualifications:

• Bachelor's degree in Nursing (BSN)
• Case Management Certification (CCM)
• Proficiency with other health care related software platforms
• High degree of independence, flexibility, initiative and commitment

Our Commitment Prosano Health Solutions does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Prosano Health Solutions.

Imagine doing life-changing work and helping more than one million Arizonans live healthier and longer lives. That’s the kind of satisfaction you’ll find when you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming healthcare for more than 80 years.