Health Manager

• Assists leadership in the design, implementation and evaluation of health management programs to support overall the Health Plan goals and strategic business strategies.
• Receives referrals for health management, assures appropriateness of member referrals, and triages and stratifies members according to assessed needs for enrollment into Health Management programs.
• Utilizes established education pathways to direct comprehensive and consistent disease management education to members.
• Assesses physical, social, and functional status to direct education and management activities.
• Coordinates services and serves as a resource to members, families, and staff for all Health Management programs.
• Collaborates with primary care providers to enhance evidence-based clinical guideline adherence and promote best practice by initiating and adjusting therapies as directed by the practitioner and providing approprionitoring as needed.
• Facilitates and coordinates laboratory and diagnostic tests for all disease management programs.
• Continuously evaluates members progress toward desired health outcomes and adjusts plan of care for optimal outcomes.
• Markets the role and value of health management in disease management and case management to primary care providers, office staff and the community.
• Collects and documents data, analyzes and communicates results and documents as required for Health Management programs.
• Assesses health care needs for employer work groups and community sites, and provides appropriate health management programs.
• Collects, evaluates and documents interventions and outcomes for these programs according to Health Management standards.
• Utilizes Health Management outcomes to promote benefits and availability of disease and case management services with providers and other health care providers.
• Identifies problems, proposes process improvement strategies and assists the Care Coordination team in Quality Improvement activities.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Qualifications:

Preferred Qualifications

• Certified Diabetes Educator Certification