Clinical Health Specialist

The Health and Clinical Engagement division provides valuable health and wellness services to help people maximize their health and quality of life. Health Management is one of the most critical issues Blue Cross and Blue Shield of Alabama faces in fulfilling its responsibility to be a superior administrator of health care benefits. Our goal is to provide the highest quality benefits and services while we effectively control health care costs.

The incumbent is responsible for providing efficient, prompt, and professional service to members for any health and benefit related issues. The incumbent will have a thorough knowledge of benefits and the claims process.

In addition, the incumbent provides support in the Health Management area by screening referrals for Member Management services based on established guidelines. The goal is to engage and establish a relationship with the member to resolve benefit issues and encourage the member to take steps to improve their health. The goals are to take action to assist members to obtain a primary care physician and/or close gaps in care to improve their health.

• Bachelor's degree in a health related area or upon hire commit to actively pursue a bachelor's degree in a health related area
• 2 years of experience in a clinical setting (i.e. physician's office, clinic, hospital, home health) familiar with health benefit plans, or 2 years of experience working in health and wellness promotion
• Analytical skills to probe and determine root cause of problems to facilitate resolution of issue
• Strong customer service skills and superior phone skills
• Effective verbal and written communication skills
• Proficient computer skills
• Experience as a Licensed Practical Nurse (LPN), Social Worker, or Health Educator/Promoter preferred
• Bachelor's degree preferred

The work location for this position will be full-time remote.

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
We appreciate your interest in Blue Cross and Blue Shield of Alabama 'The Company'. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association