Health Management Advisor

This position is responsible for executing clients’ health and wellness management programs to be in alignment with their benefit strategy. Focus of the position is a subject matter expert who researches & recommends service providers, creates & implements successful plans, along with the ability to move through tasks with speed and efficiency for quality delivery.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Other duties may be assigned to meet business needs.

• Develops relationships with medical insurers and Third Party Administrators to understand details of their health management (utilization, case, disease management) and wellness programs to identify resources and capabilities that impact claims.
• Responsible for understanding medical insurers’ medical policies.
• Coaches clients through implementation and ongoing management of their health and wellness initiatives.
• Creates tools to assist clients in building, implementing, & monitoring their health and wellness programs.
• Manages client expectations by creating repeatable platforms and communication materials.
• Reviews, recommends and monitors performance of third party service providers.
• Guides client in utilizing HCW created wellness resources available in our toolkit.
• Employs CRM to manage calendar, activities, tickets and tracks program results.
• Assists HCW staff with diagnosis/prognosis of claims.
• Gathers and researches data to support high claimant review.
• Reviews data analytics with Underwriter to evaluate clients’ utilization patterns and cost drivers.
• Continuously learns & researches to stay abreast of health & wellness trends/best practices in order to recommend cutting edge programs
• and services.
• Creates and delivers presentations to educate audiences on health and wellness topics.
• Educates HCW Staff on health and wellness resources, trends, & local/national health alerts.
• Educates and builds prospect relationships to assist in the closure of a sale.
• Drafts communication materials and blogs related to medical conditions, health and wellness topics.

QUALIFICATIONS/REQUIREMENTS

• Bachelor’s degree preferred, concentration in public health, health sciences, health and wellness, or related degree; or commensurate experience.
• 2-4 years’ experience in a professional services organization, health and wellness related required.
• Proven track record managing and leading.
• Industry experience and/or product knowledge preferred.
• Familiarity with public health concepts and their application as related to organizations.
• Strong ability to understand complex documents such as contracts and plan documents.
• Ability to embrace and respect the team culture approach.
• Achievement oriented with the ability to work in teams.

KSAOs

Knowledge

• Strong knowledge of carrier/service providers’ resources, programs and terminology.
• Basic understanding of compliance as it relates to health and wellness programs.
• Strong knowledge of successful elements of health and wellness programs.
• Advanced knowledge of customer service techniques.
• Knowledge of extrapolating appropriate information from proposals.
• Knowledge of Excel and PowerPoint.
• Knowledge of company templates and how to use/modify them.
• Knowledge of basic medical terminology.

Skills

• Communication skills both written and verbal- successfully communicates with carriers, clients and internal teams.
• Excellent grammar, verbal and written.
• Listening – has the patience to hear people out and practices active and attentive listening.
• Relationship building- builds and maintains relationships with internal and external team members in order to work together more efficiently and effectively.
• Priority Setting- knows how to sense which activities should be completed prior to others and manages time accordingly.
• Organization- ability to manage multiple tasks as well as keep up with a variety of pieces of information.
• Multi-tasking – attend to and prioritize multiple and competing activities and deadlines.
• Time Management – can prioritize and self-manage a number of activities.
• Technical expertise – ability to keep up with an ever-changing industry and learn new concepts quickly.
• Problem Solving – asks questions to discover information and underlying issues; uses logic and research to solve problems.
• Customer Focused – knows how to advocate for the client and set high service standards.
• Presents to others – clearly informs and influences audiences at presentations and client meetings on health management and wellness.
• Strategic Thinking – can anticipate future consequences and trends accurately in order to create a valuable long term vision.
• Teaching – influences existing and prospective clients, as well as internal team members on the benefits of wellness programs as well as medical management.

Attributes

• Self-motivated- has the drive and focus to start and complete activities with very little direction from above.
• Detail-oriented- ability to see the details and to accurately attend to large amounts of information on a regular basis.
• Dependable – can be relied on to complete tasks and solve issues for clients in a timely manner; follows through.
• Intuitive – can instinctively anticipate client needs by relying on knowledge and past experiences.
• Team Player – knows how to utilize the knowledge and skills of team members, as well as work with and share knowledge.
• Patience – is tolerant with people and processes specifically in working with the client and tries to understand the people and the data before making judgments and acting.
• Resilience – the ability to recover quickly from difficult client situations and setbacks.
• Flexible – can effectively change interpersonal behavior quickly based on the demands of the project or the client; knows how to move with ease between everyday routine tasks and more complicated activities.
• Positive – works through everyday tasks with an upbeat attitude and knows how to see the best in situations and people.

Tools

• HCW Templates – uses premade templates to assist with the implementation process.
• InforCRM – inputs client profile data and for plan/employer information to best serve the client.
• Checklists – utilizes organization checklists in order to efficiently complete tasks and processes.
• Microsoft Office (e.g. Word, Excel, PowerPoint, Publisher, Outlook) – has an advanced understanding of these products and utilizes them to communicate, create, and update the client in support of their health and wellness plans.