TriWest Healthcare Alliance
Pharmacy Health Coach (Finance)
A Health Coach has the unique opportunity to positively impact TRICARE beneficiaries by supporting them to live healthier lives. This role spans many specialties such as Nutrition, Exercise Physiology, Clinical/Nursing, Respiratory Therapy, Counseling and Pharmacy and will spend time addressing individual health and lifestyle concerns of our beneficiaries. You will use your skills to systematically evaluate unique health concerns and collaborate with the beneficiary and their healthcare team to develop targeted goals and interventions to positively impact their health. A major part of this role is motivating and empowering the beneficiaries to embrace the changes identified and assess the effectiveness of the changes. In addition, strong collaboration with the Population Health (PH) leadership team is expected to optimize Population Health strategies and goals and implement procedures to ensure program compliance with URAC accreditation standards.
Education & Experience
Required:
• Bachelor's degree in appropriate field of specialization (Nutrition, Exercise Physiology, Respiratory Therapy, Counseling, or Pharmacy)
• Must be a U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Minimum of 3 years of experience in health education, exercise instruction or patient education; or any combination of education and experience, which would provide an equivalent background
• Certification, advanced certification, and/or licensure in appropriate field of specialty as required to practice in state of residence (I.E. RPh/Pharm D; RD/LD/LDN; RRT; EPC/ACSM-EP/ACSM-CEP/NASM-BCS; RN; LPC/LCSW/LMFT)
Preferred:
• Health Coach certification such as (NSHC or ACE)
• Direct experience in health coaching, disease management and knowledge of behavioral and/or clinical assessment techniques, health and/or patient education and behavior change techniques preferred
• Experience with a Managed Care Organization (MCO) supporting clinical programs
• Knowledge of government health care programs, TRICARE, or Medicare/Medicaid
Key Responsibilities
• Conduct initial consultations with beneficiaries to identify opportunities, anticipate complications or barriers and act to avoid them; provides health instruction to the beneficiary/family; refers the beneficiary to their health care team as needed. Non-clinical staff are not required to evaluate or interpret clinical data elements.
• Collaborates with beneficiary's health care team to achieve best overall outcome while reinforcing treatment plans and orders.
• Educate and empower beneficiaries on self-management skills to manage their chronic conditions and/or lifestyle changes.
• Under clinical supervision, develops individualized, educational plans in a timely manner. Integrates educational plans with appropriate clinical guidelines for the disease states. Transfers cases requiring more intensive management to Health Coach RN, Disease Management RN or Case Management.
• Collaborates and coordinates services with cross-functional team using disease management strategies and targeting specific disease populations. Refers to appropriate Population Health programs and other case management and care coordination programs. Collaborates with Military Treatment Facility, outside agencies, and provider networks.
• Reviews, identify and assist with SDoH health disparities and educates beneficiaries about TRICARE benefits and directs them to appropriate resources.
• Adhere to URAC standards, TRICARE policy, contractual requirements, and nationally recognized practice standards.
• Performs other duties as assigned.
Competencies
Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.
Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.
Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.
Team-Building / Team Player: Ability to manage large amounts of complex information, communicate clearly, and draw sound conclusions. Ability to organize tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail oriented.
Technical Skills: Knowledge of TRICARE programs and benefits, Managed Care, and URAC national best-practice standards; population health and disease management interventions, crisis intervention strategies, collaboration skills, legal and regulatory requirements, and HIPAA privacy regulations.
Working Conditions
Working Conditions:
• Ability to cover any work shift
• Ability to work overtime, if needed
• Onsite: Works within a standard office environment
• Remote: Private and secure workspace and workstation with high speed internet is required
• Extensive computer work with prolonged sitting, wearing of headset, typing, speaking on a phone
Company Overview
Taking Care of Our Nation's Heroes.
It's Who We Are. It's What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!
Our job is to make sure that America's heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.
Benefits
We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.