EXL (NASDAQ: EXLS) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 26,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), South America, Australia and South Africa. For more information, visit www.exlservice.com.
Health Integrated delivers health management solutions using a whole-patient approach. Our patient-specific, evidence-based health programs are built around the person, not the disease. By addressing behavioral and emotional well-being rather than focusing only on the chronic condition(s), Health Integrated is able to help people realize a higher quality of life, with more positive clinical outcomes and drive greater value for employers and health plans.
The heart of the program targets clinically complex, chronically ill members who struggle with psychosocial issues that lead to avoidable utilization and disproportionate costs.
In this highly rewarding role, we are seeking Master’s degree prepared licensed clinicians and degreed registered nurses to join the team that telephonically promotes improved health outcomes for a vulnerable, chronically ill population, using validated behavioral health interventions integrated with evidenced based clinical guidelines, disease management, care coordination and health coaching tools.
We want our Personal Clinicians to empower members with knowledge that allows them to become more active participants in their health care, to promote the highest level of physical, psychological and social functioning possible for members with chronic illnesses and to improve the overall health outcomes of participants. These team members make a difference in our members’ lives every day.
Shift: Monday-Friday 2:30-11pm and one Saturday a month at 12:30 to 9pm.
• Adheres to goals and objectives (i.e., health care cost containment; high quality of health care delivery system; meeting the member's individualized health care needs; adherence with treatment regimen; returning member to maximum functional capability) through adherence to program policies and procedures;
• Performs telephonic therapeutic/coaching activities, communicating with the multidisciplinary team in the timeframes required to meet program goals and objectives;
• Collects pertinent clinical information, documenting findings using the HI clinical information systems program;
• Summarizes and documents pertinent member data (i.e., verbal discussions with the member/member's legally appointed representative, family, practitioner, other health care providers or the health purchaser staff, and/or any conferences);
• Refers cases to where there is a threat of litigation and/or refers members specified by the legal department for immediate referral.
• Provides for supervision of non-clinical staff in the disease management program by licensed or certified staff.
• Work to ensure all programs effectiveness, quality, productivity profitability and patient safety.
• Identifies and communicates to supervisor all concerns related to patient safety issues.
• Consults with and seeks advice from licensed physicians with expertise appropriate to the types of services being managed.
• Creates and supports a positive and supportive working environment;
• Maintains a courteous and professional attitude when working with all HI staff members and the management team;
• Actively participates in any team meetings and Grand Rounds.
• Actively participates in any HI committee meetings as assigned.
• Serves as a positive role model for peers.
• Ensures that licensed health professionals are readily available to answer questions and that non-clinical administrative staff is performing within the scope of the non-clinical role.
• Works, communicates and collaborates in harmony and in a courteous and professional manner with members, practitioners, providers, health purchaser clients and their staff, and the HI multidisciplinary team;
• Timely processes and communications, identifies and resolves all issues and concerns related to the day-to-day activities as assigned/designated
• Strong communication, documentation, clinical (behavioral health), critical thinking, and problem solving skills are essential
• Able to work in a team environment, must be flexible and able to adapt to a changing environment;
• Able to work in an environment with goals, objectives and operational metrics
• Strong skills in dealing with difficult and challenging personalities and situations are essential
• Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes
• Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow
• Call center knowledge desirable
• Patient Education/Health Promotion
• High-Impact Communication
• Work Standards
• Managing Work (including Time Management)
• Nursing, behavioral health, and/or healthcare sciences degree.
• Licensed healthcare professional (RN, LCSW, LMHC, LMFT) with current, unrestricted license required.
Work Experience Requirements:
• Direct consumer/patient care in behavioral health required.
• Two years clinical experience in case management and/or mental health required.
• One to two years critical care experience/crisis management in medical practices or behavioral health practices preferred.
• Two to three years clinical call center experience preferred.