Nurse Advocate
Kansas City, United States of America
Client Services
2300VD
Working at Lockton
At Lockton, we’re passionate about helping our people achieve their ultimate potential. Our people are curious, action-oriented and always striving to make ourselves and those around us better. We’re active listeners working to ensure understanding and problem solvers developing innovative solutions. If you can see yourself delivering excellent service to clients, giving back to our communities and being a part of our caring culture, you belong here.
Business unit
Founders Series
Schedule
Full-time
Job type
Standard
Workplace
In Office
Your Responsibilities
Description:
Description:
The Lockton Nurse Advocate (LNA) is responsible for monitoring, coaching, and coordinating resources for individuals with identified health risks through the use of data analytics and health promotion initiatives. As an advocate for the patient and a steward for the employee health plan, this position assists patients to reach optimal function and health in an appropriate environment across the continuum of care in accordance with the plan provisions. The role applies the nursing process of assessment, planning, implementation, monitoring, and evaluating, while coordinating care to meet the patient's individual health care needs. The continuum of care includes the inpatient, outpatient, and community collaboration with patient, family, and health team members to ensure safe, quality, and cost-effective care.
- Provide on-site, telephonic, and/or web-based support to health plan participants
- Provide health coaching and guidance for individuals participating in the LNA and/or wellness program(s)
- Leverage all available tools and resources from the organization’s carriers, third-party administrators and other available providers and sources.
- Connect participants to appropriate health resources based on current health status and clinical judgment
- Identifies nonemergent ED utilization and communicates appropriate alternate care options for participants.
- Reviews daily Cerner report for non-emergent and high ED utilizers.
- Identifies high-risk plan participants requiring substantial care coordination through communication with inpatient care/case managers, hospitalists, primary care physicians, and health coaches.
- Daily reviews EMR and other databases for inpatient, 30-day Readmissions.
- Monitors High-Cost Claimants, Palliative Care Consults and Disease-Specific Conditions.
- Consults with medical directors for clinical and utilization direction for specific issues.
- Collaborates with Benefit’s staff researching payer denials, participant coverage requests, and other providers/participant/plan issues.
- Collaborates with Benefit’s staff on plan interpretation, Medical Policy and Care Guidelines.
- Participates in onsite Annual payer update and when requested weekly payer phone calls.
- Collaborates with Benefit’s staff researching payer denials, participant coverage requests, and other providers/participant/plan issues.
- Collaborates with Benefit’s staff on plan interpretation, Medical Policy and Care Guidelines.
- Coordinates Care across the continuum (inpatient, outpatient, community) to assure appropriate utilization of clinical and community resources.
- Collaborates with health coaches for high-risk and repeat Emergency Department utilizers.
- Collaborates with independent and out of network providers to design plans of care and follow up for appropriate resource utilization.
- Refers complex participants to appropriate resources such as disease management professionals, specialist, palliative care, pharmacist, pastoral, psychological and Employee Assistant Program (EAP).
- Promotes and refers plan participants to health plan programs such as Better Living Programs: Enhanced Diabetic Self-Management, Weight Management, Tobacco/Nicotine Free Resources and others as identified.
- Monitors participants for continued needs and acts as a resource as needs are identified.
- Promotes and encourages participation in Wellness and Enhanced Benefit Programs through educational displays, written and verbal communication.
- Document client out-reach, engagement, and follow-up
- Review and monitor InfoLock medical and pharmacy claims data
- Share the responsibility of maintaining program timelines and resources with the Nurse Advocate project manager and other key contacts
- Assist in the development and presentation of health and wellness-focused information and educational programs
- Assist with the content of client reports based on participation and adherence.
- Contribute to the content of quarterly/semi-annual/annual LNA reports.
- Collaborates with HR Business Analyst for statistical analysis of Health Plan data.
- Participates in mandatory in-services and/or CE programs as mandated by policies and procedures/external agencies and as directed by management.
- Follows and understands the mission, vision, core values, Employee Standards of Behavior and company policies/procedures.
- Remain current of health promotion industry trends, products and best practices.
- Perform biometric measurements as needed
- Ability to work flexible hours if needed.
- Other duties as assigned.
#LI-SS1
Qualifications
Qualifications:
To perform the job successfully, an individual should have the following education, competencies, and experience:
Education, Experience, and Competencies
- Bachelor of Science in Nursing
- Minimum of three years nursing experience working with chronic conditions and condition management
- Experience in health benefits navigation, utilization management, medical and pharmacy data analytics and pre-certification preferred.
- Current unencumbered Registered Nurse Licensure
- Current BLS certification
- Competence in Microsoft office, web-based program use, and an ability to readily learn new computer-based skills
- Health or wellness coaching, case management, disease management experience preferred
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The physical demands described here are those which must be met while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Proficiency in critical thinking and ability to deal with issues using solid nursing judgment and sound decision-making
- Ability to plan and coordinate care across the healthcare continuum.
- Ability to initiate patient and family engagement to promote self-care management.
- Effectively organize large caseloads and prioritize work demands
- Accountability and autonomy
- Promote and assist with enhanced benefit programs.
- Skills in organization, team collaboration, and coordination with projects.
- Ability to effectively communicate both verbally and in writing.
- Ability to capture data with the use of MS Excel or similar software applications.
- Exceptional communication and relationship-building skills
- Ability to work early mornings, occasional evenings
- Ability to operate office and medical equipment
- Occasional overnight travel (10% of time) for client meetings, training and/or corporate meetings
Equal Opportunity Statement
Lockton Companies is proud to provide everyone an equal opportunity to grow and advance. We are committed to an inclusive culture and environment where our people, clients and communities are treated with respect and dignity.
At Lockton, supporting diversity, equity and inclusion is ingrained in our values, and we believe that we are at our best when we fully embrace everyone. We strive to cultivate a caring culture that learns from, celebrates and thrives because of our breadth of differences. As such, we recognize that recruiting, developing and retaining people with diverse backgrounds and experiences is vital and enabling our people to thrive personally and professionally is critical to our long-term success.
About Lockton
Lockton is the largest privately held independent insurance brokerage in the world. Since 1966, our independence has allowed us to serve our clients, take care of our people and give back to our communities. As such, our 10,000+ Associates doing business in over 100 countries are empowered to do what’s right every day.
At Lockton, we believe in the power of all people. You belong at Lockton.
How We Will Support You
At Lockton, we empower you to be true to yourself in all that you do. Your success is our success, and we provide opportunities to help you grow and create a rewarding career path, however you envision it.
We are ready to meet you where you are today, and as your needs change over time. In addition to industry-leading health insurance, we offer additional options to support your overall health and wellbeing.
No Agencies Please
Any Employment Agency, person or entity that submits an unsolicited resume to this site does so with the understanding that the applicant's resume will become the property of Lockton Companies, Inc. Lockton Companies will have the right to hire that applicant at its discretion and without any fee owed to the submitting Employment Agency, person or entity. Employment Agencies, who have fee Agreements with Lockton Companies must submit applicants to the designated Lockton Companies Employment Coordinator to be eligible for placement fees.
Similar Vacancies
View allLife at Lockton

May 31, 2023

May 26, 2023

May 8, 2023

April 20, 2023