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

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.

Job duties include but are not limited to:

• 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 corporate programs such as, Healthy Addition, New Directions and Care Management
• Coordinating care for members as appropriate using a personalized care plan
• Host Customer Video Appointments
• Educate members on digital platforms such as Blue for Me and MeQuilibrium

Job Requirements:

• 1+ year of related work experience. Experience Details: Nursing
• High school diploma or GED
• Active RN - Registered Nurse - Florida RN State Licensure And/Or Compact State Licensure
• Active BCLS - Basic Life Support CPR Certification
• Health Coaching Certification within 6 months (180 days) after hire that will remain current during employment
• Knowledge and understanding of benefit plans
• Knowledge of healthcare continuum
• Experience with automated medical systems

Preferred:

• 3 or more years' managed care, case management, disease management, clinical nursing, home health care or related experience with hands-on patient interaction
• Sales work experience
• Knowledge of benefit plans
• Knowledge of provider contracting and reimbursement methodologies
• Knowledge of member tools such as the Member Portal
• Knowledge of care management, disease management and similar care programs
• Knowledge of health and specialty products and ability to inform others of how to use benefits in conjunction with specific illnesses
• Knowledge of community resources

General Physical Demands

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

Physical/Environmental Activities

Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally May be exposed to outdoor weather conditions of cold, heat, wet, and humidity. Occasionally May be exposed to outdoor or warehouse conditions of loud noises, vibration, fumes, dust, odors, and mists.

What We Offer:

As a Florida Blue employee, you will be at the heart of GuideWell's vision - to lead the nation in transforming health through compassionate, connected, and technology-enabled care that delivers personalized value and empowered living.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan including employer match;
• Paid time off, volunteer time off, 10 holidays and 2 well-being days;
• Additional voluntary benefits available; and
• A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Annualized Salary Range: $65,600 - $106,600

Typical Annualized Hiring Range: $65,600 - $82,000

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.