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

Clinical Care Guide (RN)

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.

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.

Responsibilities:

• 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
• Working hours include morning, night, or weekend hours

Requirements:

• 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

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. If interested in this position, please apply.