FL Blue Center Nurse RN - Miami (Bilingual/Spanish)

About the role

Love engaging with people to help them achieve better health? Come join the exciting, rapidly expanding Direct-to-Consumer team. We make it our priority to utilize our skills and knowledge to help members make positive changes in their health and well-being. While on this team you will proactively manage prospective customers and members' experience through the health care continuum and delivery system in a Florida Blue Center environment by assessing needs, educating on benefit plans, costs, choices, tools and programs and referring to Florida Blue programs and resources as appropriate. Contacts and referrals can come from a variety of internal and external sources, including member self-service, Care Managers, the member contact center, third party vendors such as Health Dialog, wellness/health fairs and GuideWell Enterprise Channels. Present health education classes and programs to members and non-members. Perform Personal Health Assessments on members and provide education on ways to achieve better health.

Responsibilities

• Provides personal, care engagement and assistance with coordination of health care benefits and services to prospective customers and members in the Direct-to-Consumer Channel by:
• Performing Personal Health Assessments and providing education on the biometric results
• Closing member care gaps by accurately documenting test results in the clinical record
• Presenting health education classes and programs
• Performing prospective customer and member needs assessment in order to provide the most effective and efficient customer service
• Collaborating with various teams to improve the Enterprise STARS rating through targeted member campaigns
• Participating in outbound call campaigns to members for Enterprise Partners, including Commercial, U65, and Medicare teams
• Facilitating benefit savings for members by proactively educating them on benefit plan impacts and choices
• Facilitating problem solving and issue resolution; e.g. assists with access to care issues
• Providing referrals to community resources such as elder care
• Educating prospective customers and members on benefits structure and care setting alternatives
• Educating prospective customers and members and helping them access and understand cost and quality comparisons
• Providing appropriate referrals to other