A Disease Management Specialist will coordinate all services for the client and members. The Disease Management Specialist will:
∙ Direct care on site Disease Management/Case Management for client’s who are enrolled in the program;
∙ Provide face-to-face assessments with the member and their family;
∙ Contact and follow-up on clients with chronic disease states to promote changes in lifestyle and regular attendance to medical appointments;
∙ Organize educational programs for employees and management staff;
∙ Negotiate with workplace management to assist with work accommodations for employees with chronic illnesses as needed;
∙ Attend physician appointments and/or coordinating with hospital staff for members who have and acute or chronic illness to maximize treatment options and member compliance;
∙ Maintain a Disease Management/Case Management case load for members who are admitted to the Disease Management Program. The Specialist will track compliance and outcomes for the program;
∙ Assist with applications for Short Term, Long Term and Social Security Disability as appropriate;
∙ Design, promote and implement a Healthy Pregnancy Program specifically for the needs of the group;
∙ Coordinate with Dobson and Associates, LLC, TPA and Stop Loss Carriers as appropriate for high risk/high dollar clients.
∙ Provide Health Fair services at least twice a year. Health Fairs can be held at varying times at the client’s request to meet the needs of staff working various shifts;
∙ Provide Claims Review and contact with members with high dollar claims;
∙ Provide education of supervisors/management regarding specific member needs as appropriate;
∙ Provide Risk Assessment and Health Questionnaires to identify potential members at risk;
∙ Coordinate with Claims and Utilization Management programs;
∙ Provide coordination and communication with client and/or client representatives.
