Wellness Programs Specialist

Cambridge MA 02141 58 Charles Street

Job Description

Responsible for the development and operation of population based programs for members with chronic conditions, the preventive care program, and initiatives which support healthy lifestyles. Engages with individual enrollees who have a targeted health condition. Motivates enrollees to learn and adopt self-management techniques to maintain their health and wellness. Designs and conducts group programs and workshops for enrollees, their families and supports. Serves as an expert resource for staff, providers, and community agencies. Contributes to reduction of inpatient and outpatient utilization through improved self-management of conditions. Advocates for members to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process

Essential Functions


-Responsible for delivering disease management services to a defined panel of enrollees based on established member selection criteria, interventions, and program policies and procedures. Assesses enrollee needs and works with enrollees to identify goals and interventions to improve member?s ability and/or motivation to self-manage their conditions. Develops and implements care coordination plans for enrollees. Receives inbound and make outreach calls to enrollees in order to educate and motivate them in self-management. Assists in the coordination of medical and behavioral care. Identifies and removes barriers to accessing services.
-Develops and implements programs to maintain healthy lifestyles using evidence-based approaches and engagement strategies. Collaborates with national and local clinical and peer leaders to leverage resources and expertise. Researches best practices; gathers input from enrollees and staff; pilot tests approaches for delivery.
-Designs, organizes, and delivers workshops for groups of enrollees. Develops processes for scheduling and managing group sessions.
-Participates in Care Coordination Team meetings and consults with Physician Advisors/Medical Directors on regular basis concerning the progress of enrollees.
-Maintains an active work load in accordance with performance standards.
-Works with community agencies as appropriate.
-Performs data gathering, documentation, and analysis as appropriate.

General Job Information

Title

Wellness Programs Specialist

Grade

23

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

2/8/2019

Date Requisition Created

2/8/2019

Minimum Qualifications

Education

Bachelors: Nursing (Required), Masters: Public Health

License and Certifications - Required

RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Expert in disease management specific to condition management. Ability to identify medical and behavioral symptoms via phone. Ability to identify gaps in evidence-based care. Possesses an understanding of medical tests performed on members. Knowledge of co-morbid disease risk factors. Proficient in pharmacology. Ability to understand disease inflection points to capitalize on clinical windows of opportunities. Ability to apply treatment objectives/findings from evidence based guidelines. Ability to function independently and as a team member. Good organization, time management and communication skills. Excellent presenter for large and small groups. Ability to engage enrollees and quickly build rapport. Proficient using computers, Microsoft Office applications, web, materials and tools.5 years post degree experience.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”