Health & Wellness Advisor I (Partnership in Care)

3 weeks ago


New York, United States MetroPlusHealth Full time

Position Overview

With the support of the Health & Wellness Advisor II, the Health & Wellness Advisor I ensures the promotion of health and wellness among HIV-positive members and other members at high-risk for HIV by conducting high-volume outreach to assess their health and psychosocial needs and support them to stay in care and adherent to medication. The Health & Wellness Advisor I works in conjunction with the Health & Wellness Advisor II and other colleagues in a team-oriented approach with a focus on establishing member rapport.

Job Description

Promotes access to and oversees the coordination and delivery of comprehensive, quality healthcare services for members who are living with HIV, transgender, and homeless. Performs telephonic care management activities including assessment, plan of care development, care coordination, out-patient follow-up, and ancillary service review to ensure optimum health outcomes. Develops and implements an individualized, member-centered Plan of Care through direct telephonic and face-to-face member engagement, and inclusion, where appropriate, of collateral contacts including family members (with appropriate consent of the member), primary care provider, and other community and case managers to identify and address the needs and barriers of members living with HIV (and others in the Special Needs Plan) to promote the health and wellness of the member. Provides health education using coaching and motivational interviewing techniques to promote improved health outcomes for HIV engagement in care and viral load suppression, engagement with behavioral health and substance use services and effective management of other co-morbid illnesses, such as hepatitis C, diabetes, hypertension, and asthma/COPD. Participates in special outreach and quality improvement projects as assigned. Documents all care management activities for each member and ensures that such documentation is in compliance with professional standards and regulatory guidelines using the correct templates.  Addresses member primary care provider assignment during outreach and reassigns members as appropriate.  Carefully follows designated departmental compliance, care management, and quality improvement and workflows as assigned.  Escalates cases and issues to their supervisor as appropriate.  Answers calls on the in-bound call center telephone line in a professional and timely manner.  Attends and prepares for case conferences, including Medicare interdisciplinary case conference and conferences on special topics and/or with other departments.  Orients assigned new members to MetroPlusHealth and the scope of services the plan provides as needed. Ensures that coordination of membership enrolled in all lines of business is compliant with Federal, State, and City regulations, and are consistent with the Mission, Vision and Values of the organization

Minimum Qualifications

Bachelor’s degree from an accredited college or university in a healthcare-related field is required.  A minimum of two years of clinical experience in HIV care or support systems that includes experience in care coordination, health education and case management. Master’s degree from an accredited college or university in Nursing, Social Work or other healthcare related discipline is preferred. A minimum of two years of experience in managed care is preferred.

Professional Competencies

 Integrity and Trust Customer Focus Functional/Technical Skills Written/Oral Communications

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