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Colleague Health Plan Navigator

4 weeks ago

Grand Rapids, United States Trinity Health Full time
Employment Type:
Full timeShift:
Day Shift

Description:

Position summary:

The Colleague Health Plan Navigator ("Navigator") provides care navigation and other related services for members of the Trinity Health Colleague Health Plan ("Plan"). The Navigator supports the management of care to assist in meeting the multiple healthcare needs of the member, ensure continuity of services, and to decrease fragmentation of care and services. The Navigator supports members, member support person(s), and providers to promote cost effective quality clinical outcomes. The Navigator works as part of a distributed system-wide team with direct oversight from the Trinity Health Population Health and Total Rewards leadership.

What the Colleague Health Plan Navigator will need:
  • Bachelor's degree Human Resources, Nursing, Marketing or related field, or equivalent combination of education and experience. At least three (3) years of relevant work experience with health plans, provider networks, and/or medical group practices and in-depth knowledge and understanding of the healthcare system.
  • Comprehensive knowledge of applicable laws and regulations (e.g., HIPAA, etc.)
  • Must be discrete and maintain the highest level of confidentiality with extremely sensitive and protected data.
  • Ability to respond to variable situations requiring analytical, interpretative, evaluative, and constructive thinking abilities. Strong logical and deductive reasoning abilities.
  • Strong analytical and problem-solving skills to handle reasonably complex situations from both a micro and macro perspective while considering a broad range of issues/factors, and ability to recommend creative solutions.
What the Colleague Health Plan Navigator will do:
  • Maintains working knowledge of the assigned healthcare market including the provider network composition, availability of services, care management resources, and community services and resources.
  • Directs members to appropriate providers (physicians, facilities, urgent care centers, etc.), programs, information, and resources.
  • Assists members in establishing a primary care relationship and / or any specialty or ancillary care, including educating and supporting members in navigating the provider network and care management resources.
  • Identifies early trends (e.g., difficulty scheduling services, lack of availability, etc.), establishes and measures key performance indicators, provides continuous feedback to the local market and the Plan on opportunities, and facilitates related actions. Collaborates with system-wide Navigator team in this work. Uses standard documentation tools and data collection tools to accomplish this.
Benefits and Total Rewards:
  • Competitive salary, paid time off, 403B retirement savings, and health, vision, dental benefits starting on Day 1- no waiting period
  • Colleague Referral Program to earn cash and prizes
  • Unlimited career growth opportunities with one of the largest Catholic healthcare organizations in the country
  • Trinity Health offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

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