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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in health management and risk prevention initiatives, particularly for pregnant women and individuals with chronic conditions. Proficient in conducting claims audits, monitoring healthcare utilization, and collaborating with multidisciplinary teams to provide effective health guidance.
Highest-signal resume keywords
Registered Nurse (COREN)Health ManagementChronic Condition MonitoringClaims AuditsBasic Excel Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Health ManagementChronic Condition MonitoringClaims AuditsTelephone-Based MonitoringHealthcare Plan Utilization Analysis
Soft Skills
CommunicationCollaborationPatient Support
Tools & Technologies
SpreadsheetsHealthcare Systems
Certifications & Qualifications
Registered Nurse (COREN)
Industry Keywords
Risk Prevention InitiativesHealth CampaignsVaccination CampaignsCorporate Healthcare SettingMultidisciplinary Team
About the role
Key responsibilities & impact- Work in health management, planning and promoting risk prevention initiatives for pregnant women, individuals with chronic conditions, high users, and frequent healthcare users
- Conduct claims audits and perform health management activities alongside primary care physicians at the client company
- Support health campaigns and educational talks
- Serve as the health point of contact for employees at the client company
- Monitor beneficiaries with musculoskeletal conditions and provide treatment guidance in collaboration with the occupational physician
- Analyze and audit healthcare plan utilization by the highest users, assess medical expenses, treatments, and spending trends, and provide health guidance
- Identify eligible pregnant women and individuals with chronic conditions and refer them for monitoring by the health plan provider
- Support vaccination campaigns, SIPAT, and Health Week initiatives
- Schedule appointments and examinations for employees and answer questions about healthcare and provider networks
- Prepare emails, reports, and records using systems and/or spreadsheets
- Participate in technical meetings, presenting results and discussing cases with a multidisciplinary team
- Visit hospitalized beneficiaries to provide support and conduct audits
Requirements
What you’ll need- Registered Nurse with an active professional license (COREN)
- Graduated more than 4 years ago
- Experience in a corporate healthcare setting (clinic and/or remote monitoring)
- Experience monitoring patients with chronic conditions and/or pregnant women
- Experience with telephone-based monitoring (not required, but considered an asset)
- Basic Excel skills
- Specify place of residence and/or travel time to the office
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Meal or food allowance
- Transportation allowance
- Life insurance
- Profit-sharing and results-based bonus
- Excellent workplace culture in a welcoming, supportive, and dynamic environment
- Birthday day off
- Pharmacy benefits card
- Partnership with Sesc
- Discounts on our insurance products
- Discounts on cinema tickets
- Hybrid work-from-home arrangement for eligible employees