QM Health Navigator
2 weeks ago
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Position Overview
The primary function of the Quality Management (QM) Health Navigator is to outreach members missing important health screenings (i.e., HEDIS/QARR gaps in care) to assist in coordinating needed appointments for a variety of clinical and social services and ensuring maintenance medications are filled regularly. The QM Health Navigator will serve as a source of empowerment for MetroPlusHealth members, educating on the importance of, and motivating them to complete, needed services and providing support as the member navigates the health care system, all with the goal of maximizing performance in the organization’s quality reporting programs and health outcomes.
The QM Health Navigator will also play a vital role in identifying and collecting data on the existence and prevalence of healthcare barriers. In addition to addressing the barriers with the member, this data will be used to inform future planning for care access, health equity and needed network expansions and shape the organization’s overarching quality strategy, helping to ensure high-quality of care to all New Yorkers serviced by MetroPlusHealth.
Each QM Health Navigator will be responsible for one of the following domains of care: Women’s Health, Chronic Conditions or Child/Adult Screenings and Immunizations.
Job Description- Telephonically outreach members to assist them with appointments for primary and specialty care, educational classes, and transportation.
- Assist members with filling maintenance medications regularly and on-time. This includes helping members secure new scripts/refills and assisting them in enrolling in home delivery services.
- Educate members on the importance of regularly receiving needed services using evidence-informed approaches. Coach and motivate them to engage in care.
- Develop and maintain effective working relationships with members and providers.
- Collect data on the existence and prevalence of healthcare barriers and social needs. Assist members with navigating the healthcare system and provide basic benefit information as needed.
- Promote communication with the Care Management team and other internal departments to ensure continuity of care and to foster member satisfaction.
- Share observations and provide feedback regarding workflow to ensure continuous quality improvement.
- Maintain accurate and complete documentation of required information in compliance with risk management and regulatory requirements.
- Perform data entry of medical information; maintain tracking process and reports.
- Comply with all orientation requirements, annual and other mandatory training, organizational and departmental policies and procedures and actively participate in the evaluation process.
- Maintain professional competencies as a Quality Management Health Navigator.
- Perform ad-hoc projects as assigned
- High school diploma or GED required. Bachelor’s Degree preferred.
- 3+ years of experience in client relations/providing customer service, preferably in the medical field working with the health needs of patients
- Working knowledge of medical terminology and abbreviations.
- Must know how to use Microsoft Office applications including Word, Excel, and Outlook.
- 1-3 years Managed Care Experience, preferably in Care Coordination, a plus.
- Experience in Motivational Interviewing is a plus
- Experience as a Medical Assistant or Licensed Vocational Nurse is a plus.
- Bilingual candidates are strongly preferred.
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical/Analytical Skills
- Teamwork
- Written/Oral Communications
- Strong customer service skills to coordinate service delivery including attention to members/caregivers, sensitivity to concerns, proactive identification and rapid resolution of issues to promote positive outcomes for members.
#LI-Remote
-
QM Health Navigator
13 hours ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
QM Health Navigator
2 days ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
QM Health Navigator
2 days ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
QM Health Navigator
2 days ago
New York, NY, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
QM Health Navigator
Found in: Careerbuilder One Red US C2 - 1 day ago
New York, NY, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
Director, QMS
3 days ago
New York, United States CareerBuilder Full timeJob Title: Director of Quality Management Systems (QMS) About: Our client is a dynamic and innovative biotechnology company located in the San Francisco Bay Area. They are dedicated to advancing healthcare through groundbreaking research, development, and commercialization of novel therapeutics. With a commitment to quality, integrity, and...
-
Patient Health Navigator
2 days ago
New York, United States CINQCARE Full timeJob DescriptionJob DescriptionCINQCAREPatient Health NavigatorPosition DescriptionOverviewThe Patient Health Navigator reports to the Director of Care Management, with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s...
-
Patient Health Navigator
1 week ago
New York, United States CINQCARE Full timeJob DescriptionJob DescriptionCINQCAREPatient Health NavigatorPosition DescriptionOverviewThe Patient Health Navigator reports to the Director of Care Management, with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s...
-
Health Navigator
1 week ago
Granite City, United States Chestnut Health Systems Full timeOverview See tangible results as you help patients to navigate the sometimes complex world of health care. Chestnut Family Health Center in Granite City, IL seeks a full-time health navigator to coordinate care for patients who need some extra support and guidance. Responsibilities Help facilitate patient access to quality primary and behavioral health...
-
Health Navigator
Found in: Careerbuilder One Red US C2 - 1 day ago
HAMILTON/New York/US Main Street Rural Health Full timeOverview: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team and providing personalized assistance with...
-
Health Navigator
1 week ago
Watertown/New York/US Main Street Rural Health Full timeOverview: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team and providing personalized assistance with...
-
Health Navigator
2 weeks ago
Silver City, United States Main Street Health Full timeJob DescriptionJob DescriptionJob Description: Health NavigatorAbout Us: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team...
-
Health Navigator
22 hours ago
Silver City, United States Main Street Health Full timeJob DescriptionJob DescriptionJob Description: Health NavigatorAbout Us: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team...
-
Health Navigator
1 week ago
New Hartford, United States Main Street Health Full timeJob DescriptionJob DescriptionHealth Navigator Role DescriptionAbout Us: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team...
-
Health Navigator
1 day ago
New Hartford, United States Main Street Health Full timeJob DescriptionJob DescriptionHealth Navigator Role DescriptionAbout Us: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team...
-
Health Navigator
1 week ago
Granite City, IL, United States Chestnut Health Systems Full timeOverview See tangible results as you help patients to navigate the sometimes complex world of health care. Chestnut Family Health Center in Granite City, IL seeks a full-time health navigator to coordinate care for patients who need some extra support and guidance. Responsibilities Help facilitate patient access to quality primary and behavioral health...
-
Health Navigator
Found in: Resume Library US A2 - 1 week ago
Plattsburgh, New York, United States Hire Velocity Full timeOverview: We are a healthcare company focused exclusively on serving rural communities. We built our business to make it easier for rural patients to access care. We partner with rural primary care partners to meet patients where they are by becoming an extension of their current healthcare team and providing personalized assistance with...
-
PATIENT NAVIGATOR
Found in: Careerbuilder One Red US C2 - 5 hours ago
New York, NY 10176, USA, United States Apicha Community Health Center Full timeApicha Community Health Center's mission is to provide affordable healthcare for underserved and vulnerable people living in the New York City boroughs and on the lower east side of Manhattan. The phrase we care embodies everything that Apicha does. Whether it's our approach to otherized people, the LGBTQ+ community, individuals living with HIV/AIDs, or...
-
Nurse Navigator- Head and Neck, surgical oncology
Found in: beBee jobs US - 1 week ago
New York, New York, United States Hackensack Meridian Health Full time: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another...
-
Patient Care Navigator
1 week ago
New York, United States Strong Children Wellness Full timeAbout Us Strong Children Wellness operates a dynamic network of primary care practices seamlessly integrated into community-based organizations that focus on children and families. Our trailblazing healthcare approach holistically addresses medical, behavioral, and social needs under one roof. Pioneering a 'reverse integration' model, we offer families a...
