Health Advocate Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the health advocate job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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938 Lindsey Field

Dallas

+1 (555) 734 7318

938 Lindsey Field

Dallas

Phone

p +1 (555) 734 7318

Experience Experience

Boston, MA

Behavioral Health Advocate

Boston, MA

Yost-Goodwin

Boston, MA

Behavioral Health Advocate

Consistently provides supervision for assigned patients
Facilitate psycho-educational groups
Clearly documents observations of patient behavior
Ensures safety of patient at all times
Ensures Patients Rights and Confidentiality are maintained
Escorts patients to events away from the facility such as recreational and other activities, Court for conservatory or other hearings, Emergency Room or clinician office as necessitated by their physical condition
Promotes a positive working environment by demonstrating respect and tolerance for age, gender, race and choice of lifestyle

Houston, TX

Health Advocate Claims Supervisor

Houston, TX

Rodriguez-Predovic

Houston, TX

Health Advocate Claims Supervisor

Assist in the selection, coaching, mentoring and discipline of all staff on the team
Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts
The nature of the work in this position is sedentary and the incumbent will be sitting most of the time
Provide quality customer service that exceeds customer expectations and improves level of service being provided
Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided
Cooperate with team members to meet goals or complete tasks
Coach, mentor, and evaluate the performance of an assigned team

present

Phoenix, AZ

Shield Concierge Health Advocate Lead

Phoenix, AZ

Kertzmann-Abbott

present

Phoenix, AZ

Shield Concierge Health Advocate Lead

present

Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC
Researches opportunities for improvement in assessment methodology and actively promotes continuous improvement
Position is onsite daily, and will work with team to cover M - F 8 AM - 8 PM and occasionally Saturday 10 - 6 PM
Works on projects independently
Demonstrates cultural competence to work effectively, respectfully, and sensitively within the clients’ cultural context
Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases
Monitors Clinical Support Coordinators (non-clinical) in the performance of UM support activities

Education Education

Bachelor’s Degree in Mental Health Field

University of Kentucky

Bachelor’s Degree in Mental Health Field

Skills Skills

Allscripts Enterprise and/or IDX experience highly desirable
Ability to transfer knowledge to patients with diverse cultural backgrounds while effectively coordinating their care
Excellent verbal and written communication skills with ability to read, write, speak and understand English clearly
Basic understanding of managed care principles
Good critical thinking skills and resourcefulness
Ability to problem-solve to effectively assist patient with issues and challenges
Basic Microsoft Office skills
Ability to effectively use organization’s health information technology resources in patient management
Ability and willingness to travel between Ministry Locations
Proficient in all Microsoft Office applications including Word and Excel

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Health Advocate Appeals Supervisor Resume Examples & Samples

Minimum of 3 years of healthcare, health plan or benefits experience required preferably in a call center environment
Minimum one year lead or supervisor experience preferred
Minimum 2 years of health benefits or health insurance appeals experience
Minimum 1 years of claims or claims processing experience
Group Health Plans (fully insured and self-insured)
Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)
Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP
COBRA
Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans
High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)
Flex Spending Accounts (FSA), including limited FSAs
Coordination of benefits and which plan is primary - simple and complex cases (commercial plans, Medicare plans) *Pharmacy benefits including injectable medications
Individual Health Plans and Exchanges plans
Reviewing, interpreting, and researching Explanation of Benefits (EOB's) and denial letters
Understanding of health plan authorizations, including medical policy and claims payment guidelines to evaluate if appeals require clinical or administrative review
Knowledge of applicable law and resources regarding confidentiality of privileged patient information and appeals administration
Understanding of insurance carrier claims processing
Knowledge of procedure and diagnosis coding (ICD-9, HCPCS, and CPT-4)

Personal Health Advocate Resume Examples & Samples

Minimum of four years' experience in medical management, clinical nursing, case or disease management, health benefit plans, health insurance, home care services, or related field is required
Minimum of one year telephone triage or call center background preferred
Strong communication skills and phone etiquette
Strong ability to explain complex issues to members in simple, understandable terms
Highly effective listening skills
Strong problems solving/issue resolution skills
Excellent customer service and customer resolution skills
Strong organizational and administrative skills

Health Advocate Care Manager Resume Examples & Samples

Provides telephonic assessment and referral and/or short-term problem resolution and referral for members or their family members who contact us for assistance
Performs initial triage of calls and performs crisis stabilization, where warranted
Frequently makes decisions to adjust his/her schedule to manage crisis calls and determine and provide appropriate critical clinical intervention
Assess members for risk issues and creates safety plans
Consults with supervisors, managers and/or human resource professionals who contact us for guidance regarding increasing the likelihood of members using our services
Follows up on cases in accordance with Division Standard Operating Procedures (SOP)
Participates in clinical reviews and collaborates with supervisor for treatment plans for high risk cases
Coordinates and provides on-site Critical Incident Stress Debriefing (CISDs) 24/7 as needed
Responds to after hours and weekend crisis calls for assistance
Performs other duties as assigned assisting in creating SOPs, making recommendations, etc
Experience assessing and referring individuals seeking care for variety of mental health issues including substance abuse concerns
Proven track record performing case management responsibilities
Superior customer service skills

Health Advocate Claims Supervisor Resume Examples & Samples

Responsible for the administrative functions and supervision of the Claims unit. This includes monitoring productivity, quality management, scheduling/reporting for a team of Customer Care Associates/Specialists
Provide organization, direction and staffing for all assigned service calls and case load assistance/resolution to ensure that all calls are answered in accordance with Health Advocate’s policies and procedures and service metrics
Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution
Ensure assigned staff members meet or exceed the standards, results and responsibilities of their respective positions
Coach, mentor, and evaluate the performance of an assigned team
Assist in the selection, coaching, mentoring and discipline of all staff on the team
Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts
Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Director of Operations
Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures
Cooperate with team members to meet goals or complete tasks
Provide quality customer service that exceeds customer expectations and improves level of service being provided
Treat all internal/external customers, team members and department contacts with dignity/respect
Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided
Strong leadership skills and the ability to build and supervise effective teams
Effective verbal and written communication skills to interact with internal staff, members, clients, insurance carrier representatives and providers
Analytical, assertive, self-confident and resilient
Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals
Demonstrated ability to use Microsoft Office Suite and other job specific software programs to analyze business results and recommend changes
Ability to think creatively and be able to determine best course of action based on member needs
Ability to search and identify resources through company Intranet and Internet
Familiarity with health insurance coverage
Previous experience in claims
Management or supervisory experience in a call center setting (Claims and/or claims processing supervisory experience a plus)

Behavioral Health Advocate Resume Examples & Samples

Consistently provides supervision for assigned patients
Facilitate psycho-educational groups
Clearly documents observations of patient behavior
Performs basic housekeeping tasks required to maintain patient living areas
Ensures safety of patient at all times
Ensures Patients Rights and Confidentiality are maintained
Escorts patients to events away from the facility such as recreational and other activities, Court for conservatory or other hearings, Emergency Room or clinician office as necessitated by their physical condition
Promotes a positive working environment by demonstrating respect and tolerance for age, gender, race and choice of lifestyle
Demonstrates required attendance and reliability
Assumes responsibility for professional development and ongoing education discuss personal goals for continued development with supervisor and/or DON
Promotes, by education and example, a therapeutic environment
Maintains a professional appearance and attitude at all times
Promotes safety by attending mandatory in services and complies with all safety measures initiated by the facility

Patient Health Advocate Resume Examples & Samples

A High school diploma or GED is required
A combination of education or experience equivalent to a four year degree preferred
At least 3-5 years of related experience is required in the healthcare, respiratory care, health education and instruction and/or patient education
Prior experience in health education/coaching, patient education, investigation techniques and/or behavior change techniques highly preferred
Certification as a Wellness or Health Coach helpful
Prior call center systems and experience highly preferred
Clearly, speak, read and write in English is required. The ability to speak other languages not required but helpful
Exceptional people and communication skills to effectively establish prompt rapport along with a positive and collaborative relationships with patients is highly preferred
The employee is regularly required to use hands to write, use computer, use a telephone and manipulate a document imaging system and documents
Employee continually engages in activities that require talking and hearing
This position requires constant sitting with occasional walking, standing, kneeling or stooping
The employee must occasionally lift, push pull and/or move up to 10 pounds
Specific vision abilities required by this job include close vision, distant vision and the ability to adjust focus to work on a computer and read documents
The noise level in the work environment is usually low to moderate
There is very low exposure to dust, fume, mists and odors
Temperature is indicative of a normal indoor climate-controlled environment
General lighting is generally provided via fluorescent lighting

Health Advocate Appeals Supervisor Resume Examples & Samples

Supervising workflow of all incoming calls and cases for the Appeals Department which includes developing and implementing policies and procedures
Training staff to perform specific functions and managing employee performance
Monitoring calls and auditing case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed
Implementing actions to resolve any case deficiencies which includes reviewing results with employees
Reviewing operational reports and analyzing staff needed to make the necessary adjustments and or plans to improve results
Adherence to hours worked and time spent resolving cases, case documentation, and analyzing data reports to make timely decisions and effectively implementing plans
Coordination of benefits and which plan is primary - simple and complex cases (commercial plans, Medicare plans)
Pharmacy benefits including injectable medications

Health Advocate Resume Examples & Samples

Simplify health care system guidance and drive engagement in programs across the continuum of care
Conduct provider searches and setting appointments for the consumer with the provider
Meet Quality and Customer Satisfaction requirements
Take accountability and ownership for any follow-up work needed to resolving and close issues
Take ownership of resolution of inquiries end to end
Resolve issues including benefits, eligibility and claims as needed
Pitch clinical programs as appropriate
Identify and resolving anticipated Members issues to prevent future calls
Maintain proficiency in all technical applications (technical skills and system knowledge)
Works independently and with others
Acts as a resource for others
1+ years of Customer Service experience
Completed Advocate 4 Me Training
Ability to work an 8 hour shift between 8:00 am - 9:05 pm Monday - Friday with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
1+ years of Call Center experience
Knowledge of Medicare
Knowledge of Medical Claims Billing ICD9, CPT, or HCPC codes
Healthcare experience

Licensed Vocational Nurse Health Advocate Pact Resume Examples & Samples

Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations
Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. Completed work should need only a general review by a registered nurse or physician for appropriateness and conformity with established policies/procedures
Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors
Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD
Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD, and initiate appropriate emergency interventions as directed
Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff
Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers
Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced medical staff related to support duties for these more complex, specialized tests/procedures
Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice
Responses to Occupational Questionnaire: If applying online, you will be prompted to respond electronically. If submitting via fax, you must complete the 1203FX form
CV or Resume: It must include sufficient experience and/or education. Therefore, we encourage you to submit a thorough resume that directly relates to this position. Your resume MUST include the following: the month and year for each position held, and the number of work hours per week, e.g., 03/09 - 06/11 (or Present), 40 hrs/week
VA Form 10-2850c - Application for Associated Health Occupations. (Available at the VA Forms Website: http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf)
Current Licensure must be listed in your application materials or a copy of your license must be provided with your documents, listing an expired license will result in disqualification
SF-50, "Notice of Personnel Action" - Include your most recent SF-50 that shows your current grade, step and salary. The SF-50 must also show that you are a current permanent VA Employee

Health Advocate Proactive Health Resume Examples & Samples

Actively engages a population of medically vulnerable or chronically ill patients in their care, assisting them through the process of working towards better health by providing support, encouragement, and education
Communicates with patients (and caregivers) in person, in groups, by telephone and via electronic means
Monitors patient-reported biometrics, medication adherence, reported challenges/barriers and promptly connects the patient with the appropriate resources, and/or notifies the patients care team for additional follow-up
Advocates and facilitates referrals to gain access to services and resources for patients/teammates, including assistance programs, community based services and mental health support
Assists providers offices with member specific missed appointments through outreach and scheduling
Provides customized, evidence-based patient education in a variety of areas including but not limited to weight management/exercise, tobacco cessation, stress reduction and chronic disease self-management
Advocates for help for those who frequently access inappropriate levels of care (e.g., visiting the emergency department for conditions that can be better treated by a primary care physician)

Personal Health Advocate Resume Examples & Samples

Assisting members in navigating the healthcare system by facilitating access to healthcare providers, benefit and entitled coverage information, health services, and health resources
Receive calls from members in regards to various healthcare issues (e.g., infertility, disease, medication, etc.) and determine best course of action/s to assist the members while adhering to established policies, procedures, and key performance indicators (KPIs) (e.g. case close targets, abandon rates, etc.)
Communicate clear non-prescriptive messages to members in regards to planed activities, expected results, and anticipated timeframes of medical procedures and diagnoses
Build relationships with members in order to collaborate and develop plans of action by going above and beyond members' initial requests, taking responsibility for members' case records, and encouraging members to call back with future issues/questions
Facilitate communication among members, treating physicians, and insurance carriers, which may include assisting members with asking necessary health questions to physicians or clarifying insurance plan provisions

Health Advocate Perioperative Services Pacu Resume Examples & Samples

A high School diploma or G.E.D. Certification is required. (Must provide proof at time of interview)
Must possess a valid and current Basic Life Support (BLS) certification. (Must provide proof at time of interview)
Minimum of One (1) year of experience as a Nurse Assistant is required. (Must provide proof at time of interview)
Graduate of a Certified Medical Assistant program
Valid certification as a Nursing Assistant
Bilingual (English/Spanish)
Degrees awarded outside the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U.S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview
Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen
CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor

Behavioral Health Advocate Resume Examples & Samples

Interviews clients and their families and coordinates programs and activities to meet their social and emotional needs
Provides support to care and case managers regarding the coordination of care plans for members by utilizing social service expertise to evaluate the members need for alternative services and third party intervention
Outreaches to members telephonically and/or in-person to provide health coaching and consultation and by providing guidance regarding barriers to managing health conditions
Assists members to change behaviors and to locate and access interpersonal, family and community resources that will make it easier to manage their health. Reviews benefits options, researches community resources, coordinates services, trains behavioral routines and enables members to be active participants in their own healthcare
Provides telephone follow-up to ensure members have seen their PCP and are completing their treatment plan or preventive care services a defined by the PCP or guidelines
Coordinates community resources with emphasis on the development of natural support system. Coordinates benefits, regulations, laws and public entitlement programs
Acts as a liaison and member advocate between the member/family, physician and facilities/agencies
Assists in obtaining benefits for members through community resources when benefits are exhausted or not available
Required A Bachelor's Degree in Social Work (BSW), Psychology, Counseling, Rehabilitation, or other relevant field
Required 2+ years of experience in a health care environment with client care coordination responsibilities via assisting clients to change behaviors and to locate and access interpersonal, family and community resources that will make it easier to manage their health
Preferred Other Experience in a managed care environment
Intermediate Ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Intermediate Demonstrated interpersonal/verbal communication skills Communicates effectively in person and by phone
Intermediate Ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
Intermediate Ability to work within tight timeframes and meet strict deadlines
Intermediate Ability to effectively present information and respond to questions from families, members, and providers
Intermediate Ability to effectively present information and respond to questions from peers and management
Intermediate Demonstrated problem solving skills
Intermediate Demonstrated time management and priority setting skills
Intermediate Knowledge of healthcare delivery
Preferred Licensed Bachelor Social Worker (LBSW) None
Required Intermediate Microsoft Outlook Proficient in Microsoft Office including Outlook, Word and Excel
Required Intermediate Microsoft Word Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties
Required Intermediate Microsoft Excel
Required Intermediate Other Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties

Licensed Practical Nurse Patient Aligned Care Team Health Advocate Resume Examples & Samples

Education: Graduate of School of practical or vocational nursing approved by the appropriate state agency
Full, active, current and unrestricted license as a licensed practical or vocational nurse in s State, Territory or Commonwealth of the United States
Fax your documents to 1-478-757-3144

Nursing Assistant Health Advocate Scribe Patient Aligned Care Team Resume Examples & Samples

Providing personal nursing care such as providing pre and post operative care
Support duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment
Caring for mental ill patients, including observing, recording, and reporting changes in their behavior, and providing reassurance and encouragement
Assisting surgeons and registered nurses in operating room activities, including passing instruments, maintaining sterile conditions, and draping and positioning patients
For GS-5: Only education in excess of the first 60 semester hours of a course of study leading to a bachelor's degree is creditable toward meeting the specialized experience requirements. Two full academic years of study, or 60 semester hours, beyond the second year is equivalent to 1 year of specialized experience. Determine the applicant's total qualifying experience as a percentage of the year of specialized experience required at the GS-5 level. Then determine the applicant's education as a percentage of the education that meets the requirements for GS-5. Add the two percentages. The total percentage must equal at least 100 percent to qualify an applicant for GS-5
Fax your documents to 1-478-757-3144. If you cannot complete the Application Package online, you may fax all of your materials

Shield Concierge Health Advocate Lead Resume Examples & Samples

Researches and designs treatment plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type
Implements discharge (DC) planning activities for medically complex cases
Determines appropriateness of referral for CM services
Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases
Manages member treatment in order to meet recommended length of stay
Ensures DC planning at levels of care appropriate for the members’ needs and acuity
Negotiates with employer groups when contractually required
Active CA RN License
Bachelors of Science in Nursing or advanced degree preferred
Certified Case Manager (CCM) or is in process of completing certification when eligible based on CCM application requirements
Requires significant and substantial experience in nursing, health care or related field (7+ years). 3+ years managed care experience preferred
Able to operate PC-based software programs including proficiency in Word and Excel
Demonstrated ability to independently assess, evaluate, and interpret clinical information and care planning
In depth understanding of community resources, treatment options, home health, funding sources and special programs
Extensive knowledge of evidenced based clinical practice guidelines particularly for chronic conditions
Incorporates professional judgment and critical thinking when determining medical necessity that promotes quality, cost-effective care
Working knowledge of regulatory and accreditation standards preferred (URAC, NCQA, DMHC, Case Management Society of America CMSA)
Knowledge of Coordination of Care, Medicare regulations, prior authorization, level of care and length of stay criteria sets desirable
Demonstrated and evolving competence in CM functions and standards of practice
In addition, possesses and applies comprehensive knowledge of particular field of specialization to the completion of complex assignments
If certified as a CM, maintains CCM certification through continuing competence and education appropriate to case management scope of practice
Supports CCM certification for team members by identifying opportunities for skill and knowledge development leading towards certification application
Monitors Clinical Support Coordinators (non-clinical) in the performance of UM support activities
QA and regular performance audits
Training and mentoring backup to Supervisor/Manager as needed. Previous leadership role experience preferred within an IPA/MG, and/or health plan
Position is onsite daily, and will work with team to cover M - F 8 AM - 8 PM and occasionally Saturday 10 - 6 PM
Position does not allow for telecommuting at this time (contractual requirement - all Concierge team members must be co-located)

Health Advocate Resume Examples & Samples

Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
Serves as a primary point of contact between patient and Care Team members to anticipate and appropriately address patient questions and concerns
Confirms patient understanding of HCP Primary Care Physician (PCP) assignment and educates patient of available tools, resources, appropriate new services and benefits available
Conducts Phase I of new patient orientation and assists patient with completing all HCP forms to facilitate patient understanding of HCP systems and services through the use of standardized scripts including mailings of welcoming packages, needed materials and thank you letters
Initiates data gathering and completes documentation of Health Risk Appraisal (HRA) information for hand-off to Care Manager, ensures timely completion and review of HRA by Care Manager and facilitates availability of completed document for PCP
Conducts telephonic outreach and ensures timely follow-ups after patient encounters with Emergency Department (ED) visits, Urgent Care Center (UCC) visits and inpatient hospitalizations through collaboration with PCP and ancillary staff to meet the treatment goals of patient
Facilitates communication with patient and caregiver and coordinates patient care with appropriate resource allocations, referrals and notifications that are purposeful, supportive and interconnected with Care Team Members to ensure ongoing coordinated management of patient care
Notifies Care Team Members of patient requests and need for referral and facilitates referrals as directed by PCP and Care Manager
Facilitates the identification, recommendation, appropriate enrollment and registration of patients to Disease Management, High Risk programs, Pharmacy, patient transportation and other community-based assistance or other support programs based on PCP or Care Manager’s care decisions
Assists in care delivery through the provision of scripted health education / monitoring and tuck-in calls
Expedites completion of necessary forms and paperwork, confirms mailings, receipt of pertinent mailed materials, coordinates and tracks outstanding government / plan obligations and notifies appropriate Care Team members for follow ups
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Computer literate (i.e. logging on to computer, usage of keyboard and mouse, familiarity with Windows and email applications)
Outstanding customer service skills
Excellent verbal and written communication skills with ability to read, write, speak and understand English clearly
Good critical thinking skills and resourcefulness
Ability to problem-solve to effectively assist patient with issues and challenges
Ability to transfer knowledge to patients with diverse cultural backgrounds while effectively coordinating their care
Ability to effectively use organization’s health information technology resources in patient management
Health literacy and cultural awareness skills
Basic understanding of managed care principles
Understanding of Medicare and MediCal / Medicaid benefits
Ability to concurrently perform multiple tasks
Bilingual in English and needed language (based upon demographic needs of panel)

Behavioral Health Advocate Resume Examples & Samples

Meet with community residents in need of behavioral health services that have been referred by community-based not-for-profit organizations
Assist individuals in connecting with referred resources
Initiate timely follow up calls to ensure that individuals are participating in treatment and are receiving maximum benefit from available resources
Gathers needed data and completes the referral tracking sheets and other required logs timely and accurately
Coordinates care needs with community partners, including attending meetings where the individual's needs may be addressed or need to be represented
Establish and maintain an accurate resource list of treatment facilities and community resources, updating the list as needed

Health Advocate Resume Examples & Samples

Assists in patient care management by having an assigned patient population and/or assists the Provider and Care Manager in patient care management. Actively participates in the planning, preparation and data collection on managed patients. Anticipates the needs of assigned patient population
Promotes successful program implementation and quality cost-effective outcomes within the scope of responsibility. Maintains clinical competency requirements within scope of practice. Demonstrates initiative for self-improvement and completes required competencies
Particpates as a team member and communicates effectively with the health care team. Participates in staff meetings and other interdisciplinary meetings
Demonstrates excellent communication skills. Communicates with patient/family in a clear, concise and understandable manner. Obtains confirmation that information given to patient/family was understood
Demonstrates knowledge and use of ICD-9 coding
Manages patient cases under the direction of the Registered Nurse
Schedules appointments (new and return) and ancillary tests/surgeries. Is responsible for new patient coordination
Documents/reports patient’s concerns and symptoms, reactions, and changes (appropriate to age) to licensed clinic personnel
Performs clinical documentation of all appropriate notes, in the patient’s medical record, and/or care management system both timely and accurately under the direction of the Care Management team, ensures that patient receives results of laboratory and diagnostic tests, special test instructions, and other information in a timely manner
Coordinates communication and transactions between patient, ancillary services, consultants, and physicians. Coordinates authorization required by insurance
Creates the necessary care management reports timely and accurately
Works with Utilization Management and insurance companies, when needed, to assist patient
Performs all other duties as assigned
Age-specific patient needs that employee is required to understand and meet
Knowledge of sanitation, personal hygiene and basic health/safety precautions applicable for work in a clinic setting. Knowledge of infection control procedures and safety precautions
Knowledge of computer systems and software used in functional area
Ability to speak and write effectively at a level appropriate for the job
Ability to solve problems and identify solutions
High-level customer service skills in interactions with all patients, families, and staff, including high volume and stressful situations
Ability to plan, organize, prioritize, work independently and meet deadlines
Ability to work as a contributing member of an interdisciplinary team
Ability and willingness to travel between Ministry Locations
Proficient in all Microsoft Office applications including Word and Excel
Allscripts Enterprise and/or IDX experience highly desirable

Medical Assistant Health Advocate Resume Examples & Samples

Satisfactorily completes applicable competency assessments/skills checklists
Prioritizes patient needs, identified through phone, electronic and walk-in communication, in accordance with established guidelines, standing orders, and protocols
Assists provider with examinations, procedures, treatments and interventions
Current national MA certification from one of the following national MA certifications/registrations: Registered Medical Assistant (RMA) of AMT, National Certified Medical Assistant (NCMA), Certified Clinical Medical Assistant (CCMA), or Certified Medical Assistant (CMA) of the AAMA

Medical Assistant, Ma-health Advocate Resume Examples & Samples

Prepares and maintain examination and treatment areas
Performs complete intake process as specified by physician or other providers (chief complaint, history, vital signs, height, weight, OFC, care process model data, etc.)
Administers screening tests to patients (i.e. visual tests, audiology, spirometry, EKGs, etc.) within practice type

Medical Asst-health Advocate Resume Examples & Samples

Recognizes and appropriately responds to emergency situations
Reports significant changes in patient condition or other pertinent patient information to the Physician
Following provider instructions, demonstrates accurate, timely and efficient follow through with pharmacy refills, scheduling out of clinic procedures, obtaining, reporting and tracking of lab results, leaving phone messages and distributing faxes
Actively participates in quality improvement initiatives (i.e. CQI, TQM, Lean, 100% participation, etc.)

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