In a retail center environment, provide consultative sales and service experience for customers seeking health and ancillary insurance products and information.
Job duties include but are not limited to the following:
*Face-to-face interaction with customers as well as respond to telephone and web-based inquiries
*Initiate telephonic follow-up and/or outreach
*Use web-based tools and other aids to analyze prospective customer needs and match to appropriate company products and services
*Present and explain recommended products, benefits, features, and alternatives
*Explain company sales, medical underwriting and enrollment processes to set realistic customer expectations
*Generate and act upon leads for new sales and sale of replacement and add-on products
*Schedule and conduct group and individual information sessions
*Provide support for special events and projects for the general public in the retail center and occasionally off-site
Job Requirements:
*High School diploma or equivalent
*2 or more years of experience in a sales environment
*State of Florida 2-15 Health, Life and Annuities License
*Verbal and written communication skills
*Experience with MS Word, MS Excel and MS PowerPoint, Internet and web-based tools
*Work flexible retail work hours to include evenings, weekends and holidays
Business Specific Criteria (preferred skills):
*Bachelor's degree in Marketing or related field
*2 or more years of experience in a retail sales environment
*Experience with health insurance products to include individual or group
*Bilingual (English/Spanish)
In a retail center environment, support the customer experience by assessing customers' needs and educating on health, wellness and clinical choices, costs, tools and programs.
Job duties include but are not limited to the following:
*Face-to-face interaction with customers as well as respond to telephone and web-based inquiries
*Initiate telephone follow-up and/or outreach
*Use web-based tools and other aids to facilitate and educate customers on how to use resources, tools, information and products to manage their health care and health care costs
*Conduct/facilitate health/wellness coaching and assessments, including collection of biometrics (e.g., blood pressure, blood sample)
*Facilitate administration of personal health assessments
*Provide support for special events and projects for the general public in the retail center and occasionally off-site
*Conduct individual and small group educational sessions on wellness and lifestyle topics, using tools and features for managing health and related topics
Job Requirements:
*Active Florida RN License
*1 or more year(s) of experience with hands-on patient/client interaction
*Basic Life Support Certified (BLS)
*Experience with automated medical systems
*Verbal and written communication skills
*Willingness to work flexible hours to include evenings, weekends and holidays
Business Specific Criteria (preferred skills):
*3 or more years of managed care, case management, disease management, clinical nursing or home health care experience
*Experience working with health insurance plans, terminology and benefits
*Experience working in a Sales/Marketing environment
*Experience with provider contracting and reimbursement methodologies
*Experience teaching or coaching others to use web-based tools
*Experience with local community health and wellness resources
*Bilingual (English/Spanish)
In a retail center environment, provide a customer friendly service experience for customers with questions or issues related to health care, health insurance (benefits, claims, premium payments, and enrollment) or other related topics.
Job duties include but are not limited to the following:
*Face-to-face interaction with customers
*Respond to telephone and web-based inquiries and initiate telephonic follow-up
*Use web-based tools and other aids to facilitate and teach customers to use resources, tools, information and products to manage their health care and health care costs
*Schedule and conduct group and individual information sessions
*Educate customers regarding benefits, services, products and navigational tools
*Provide support for special events and projects for the general public in the retail center and/or at other local sites
Job Requirements:
*High school diploma or equivalent
*1 or more years consultative customer service experience
*State of Florida 2-15 health, life and annuities license (or obtain within 60 days of employment)
*Excellent verbal and written communication skills
*Experience with MS Word, MS Excel, MS PowerPoint, Internet and web-based tools
*Work flexible retail work hours to include nights, weekends and holidays
Business Specific Criteria (preferred skills):
*Associates or Bachelors Degree
*Experience serving customers in a face to face environment
*Experience with financial products or services
*Experience with service of health insurance products, insurance experience, physician's office, hospital or other position in health care industry.
*Experience with account reconciliation processes
*Bilingual (English/Spanish)
Job duties include but not limited to the following:
*Provide telephonic case management of Workers’ Compensation claims by facilitating and coordinating all aspects of the injured worker’s medical care in a timely manner and with consideration to the criteria based model
*Maintain high standard of file documentation to ensure attention to detail and file accuracy
*Interact with strategic partners to obtain or clarify clinical information
*Compares clinical information against the appropriate criteria set
*Authorize medical care and practice medical costs containment skills
*Provide medical authorization in a timely manner
*Based on rotation schedule, handle after hours calls received from on-call phone
*Work collaboratively with team adjuster and assistant to ensure continuity of care
*Assist in the development of internal procedures and training concerning medical case management
*Assist with ad hoc projects as assigned
*Moderate to heavy keying is required
Job Requirements:
*Current active RN license
*3+ years in nursing with 1+ years experience performing Workers’ Compensation case management
*Experience in utilization management/cost containment
*PC skills in windows based environment experience
*Occasional travel and handle after hours calls received from on-call phone
*Excellent oral and written communication, coordination, analytical, and problem-solving skills
*Interpersonal skills and have proven ability to work in a team environment
Business Specific Criteria (preferred skills):
*Public relations and presentation skills experience
*ER or Orthopedic experience
*Bi-lingual (Spanish-English)/(Creole-English)
*CCM (Certified Case Manager) or CRRN (Certified Rehabilitation Registered Nurse) with QRP (Qualified Rehabilitation Provider) **will need to obtain within one year**
*Intermediate MS Word and Excel
*Workers’ Compensation database system (Pyramid) experience
Job duties include but are not limited to the following:
*Support and attend county medical society meetings and participate on committees
*Develop and maintain relationships with key influencers in the local market, primarily physicians in the network, hospital administrators, and medical staff leaders
*Provide support to account managers/sales reps on account presentations, problem solving and information sessions with brokers and/or key accounts
*Work closely with sales team on acquisition and retention of major national accounts
*Facilitate local market physician advisory panel to enhance communications, relationships, policy and program development, and field testing
*Support resolution of local care and network issues as identified (e.g., variability)
*Work with Network and Informatics in refining provider specific profiles
*Support credentialing process as needed
*Serve as key presenter and educator for high profile wellness events and media events with a clinical focus
*As local medical spokesperson, inform and educate marketplace on BCBSF policy, strategy and programs
*Monitor and understand future medical models and national trends in our industry, e.g. rising consumerism demand
*Provide intelligence and insights on network management issues and market strategy (e.g., delivery system trends, competitor fee schedules, physician group acquisitions, delivery system capabilities and services) as feedback for institutionalization of learning and “bottoms up” strategy input
*Develop and maintain local market provider database/physician group files as well as relationship map of key stakeholders; work with Corporate Marketing to integrate this data/information
*Interact routinely with Care Management medical directors to gather information on network physicians requiring “education” or alignment, current clinical issues and trends and inform local delivery system as appropriate
*Develop and maintain relationship with key hospital executives and participate regularly with local hospital “grand rounds” as requested by Network, Local Presence, and other divisions and speak as appropriate as representative from the health care industry from the payer side
*Participate with community giving programs to influence and focus contributions and assist in presentation
*Meet with targeted physicians to share performance data cost, use and quality, especially with those at the extremes
*Chair local physician advisory panel and serve as linkage back to statewide physician advisory panel
*Participate in all general medical director activities including participating in appeals program
*Support corporate projects as required and as deemed appropriate by supervisor and the Vice President of Care Management
*Support Blue Cross Blue Shield Association projects and initiatives as needed and deemed appropriate by supervisor and Delivery Team Leadership
Job Requirements:
*MD or DO degree from an accredited Medical school
*Licensed to practice medicine in the state of Florida without restriction or ability to obtain
*3-5 years experience in a managed care or health care organization
*Ability to provide medical knowledge to facilitate resolution of complex issues and required decisions
*Knowledge of medical economics and performance reporting methods
*Excellent presentation skills
*Broad and deep understanding of healthcare delivery systems and market dynamics
*Working knowledge of sales and marketing disciplines and ability to apply these to the medical delivery system
*Ability to travel up to 20% of the time
*Ability to work hours congruent with providers – including evening meetings
Business Specific Criteria (preferred skills):
*Advanced degree preferred
*3-5 years clinical experience
*Knowledge of West Coast Medical Community
*Experience in manage care or health care company