The Community Specialist will assist members manage their daily lives, understand, and make difficult health care choices and obtain social services, such as health care and government assistance. The position will develop and implement care plans to assist members meet their healthcare goals while working with internal and external resources to remove barriers to receiving care.
Important To Know
This role will be On-site at our North Port Center
Address: 17900 Tamiami Trail, North Port, FL 34287
Job Summary
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. The GWC Community Navigator will assist members manage their daily lives, understand and make difficult health care choices and obtain social services, such as health care and government assistance. The position will develop and implement care plans to assist members meet their healthcare goals while working with internal and external resources to remove barriers to receiving care.
Essential Functions
The essential functions listed represent the major duties of this role, additional duties may be assigned.
Identify psychosocial status, economic and physic al needs of members; assess patient’s support systems, available community resources and other factors to plan, develop, and implement an appropriate plan of care.
Serve as members’ point of contact as needed to provide education regarding benefits, network, network access and community and government agencies that are available to assist members when benefits are not available or exhausted
Assist members using motivational interviewing and health coaching skills to learn about financial, emotional, psychosocial, transportation, isolation and food insecurity issues
Assist members obtain appropriate community resources, e.g. elder care, Medicare, Medicaid, Faith Based Organizations, local foundations
Collaborate with internal and external partners to remove barriers access to care
Identify and implement continuous improvement opportunities
Coordinate care for members as appropriate based on care/treatment plan and benefit limitations.
Identify and refer members to appropriate care programs.
Provide consultation to case managers; maintain resource site
Operates as a member advocate utilizing skills that respect issues of cultural and ethnic diversity and equity for every patient and family.
Engage with members to coordinate services, build loyalty and develop trusting relationships; Assess member’s end of life planning and provide appropriate resources and referrals to assist members
Improve member retention by connecting members to the right services at the right time and place
Host Customer Video Appointments
Qualifications
Required Work Experience
3+ years related work experience. Experience Details: Healthcare Industry and Managed Care, assisting with discharge planning, linking to community resources, navigation of financial assistance programs, chronic illness resources, etc.
Required Management Experience
No Supervisory/management Experience Required
Required Education
Related Bachelor's degree required Social work
Required Licenses and Certifications
Certified Health Coach, CHC 180 Days
Extensive knowledge of community resources
Broad knowledge of healthcare industry
Strong problem solving skills
Strong collaboration skills
Ability to listen, ascertain needs, and determine appropriate action within defined scope of authority.
Preferred Education
Master’s degree Social Work
Preferred Licenses and Certifications
LCSW - Licensed Medical Social Worker - State Licensure
Additional Preferred Qualifications
Excellent computer skills Masters Degree in Social Work Bi-lingual Spanish Strong ties to community and social 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.
What We Offer
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.
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 includes employer contribution and employer match;
Paid time off, volunteer time off, 10 holidays and two flexible 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.
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 Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.
About Us
At GuideWell, we are committed to making diversity, equity and inclusion part of everything we do. We believe in hiring people who represent the communities we serve while creating a workplace that encourages a sense of belonging for everyone, no matter who you are or where you come from.
From students to former military to seasoned professionals, our family of mission-based companies are stronger because of the unique talents and skills of our employees. We believe everyone’s contribution has the power to help people and communities achieve better health. Find your new team today.
About The Team
Florida Blue, A GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communicating to achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the members first.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Other
Industries
Insurance
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