Healthcare Navigator

2 days ago

Cary, North Carolina, United States Community Care of North Carolina Inc Full time

About Us

At Community Care of North Carolina Inc, we're dedicated to transforming healthcare for the better. Our mission is to improve health and quality of life for all North Carolinians by building supportive community-based healthcare delivery systems.

We advance patient-centered practice models and connect different segments of the local health systems. This proven population health management approach delivers better health outcomes at lower costs to communities across North Carolina, including those that experience the greatest health disparities.

Your Role

As a Healthcare Navigator, you'll address the needs of our population served by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required. You'll use your exceptional communication skills to promote quality, cost-effective health outcomes.

You'll work with registered nurses, licensed clinical social workers, primary care providers, members, guardians, caregivers, family members, other care team members, and the community to coordinate a full continuum of health care services. Your holistic approach will consider unique social and cultural dynamics.

Key Responsibilities

  • Care Management Services: Provide effective care management services based on case management standards of practice to enrolled populations.
  • Member Assessments: Complete member assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual, and cultural needs to enrolled population, throughout the continuum of care.
  • Behavioral, Social, Cultural, and Environmental Strengths and Barriers: Work with members to identify and address behavioral, social, cultural, and environmental strengths and barriers as it relates to his/her diagnosis, treatment, and access to care.
  • Patient Education: Provide education to member/family about clinical diagnosis, medications, available resources, prevention, and risk factors to achieve optimal self-management.
  • Quality Monitoring: Monitor quality and effectiveness of interventions to the enrolled populations by setting patient-centered SMART goals in collaboration with the members/families.
  • Member Care Plans: Develop, review, implement, and evaluate the member care plan in partnership with the member, caregiver/guardian/family members, providers, and Care Management team members, as applicable.
  • Therapeutic Skills and Techniques: Incorporate therapeutic skills and techniques such as trauma-informed care, motivational interviewing, strengths-based, and solution-focused modalities to help members achieve healing, growth, health, and wellness.
  • Hospital/Data or Electronic Medical Record System: Utilize Hospital/Data or Electronic Medical Record system as available.
  • Referrals and Collaborations: Facilitate referrals for members/families to appropriate community-based services and agencies. Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment outcomes.
  • Community Provider Agencies: Engage and maintain collaborative relationships with community provider agencies that promote quality care and cost-effective health care utilization.
  • Liaison: Serve as a liaison among the member/family/guardian, community services, primary providers, specialists, and other care team members to coordinate services without duplication.
  • Respect for Member Values: Respect member's values, experience, and help to empower members to be an advocate for their own care.
  • Documentation and Productivity: Maintain appropriate member documentation in the Care Management documentation platform, in accordance with organizational policies and procedures. Meet monthly productivity and role expectations.
  • Adherence to Policies and Regulations: Understand, uphold, and abide by CCNC company and department policies, goals, standards, and objectives. Adhere to CCNC privacy, security policies, and HIPAA regulations to ensure that patient and company data are properly safeguarded.
  • Travel and Training: Attend departmental and corporate meetings, local and regional training, or other events as required. Travel using personal vehicle will be required within the region and/or the State.

Qualifications

Registered Nurse (RN)

  • Graduation from an accredited school of nursing
  • BSN preferred
  • Active, unrestricted RN license to practice in North Carolina
  • Minimum 2 years' nursing experience; 1-year care management or community-based nursing preferred
  • CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
  • Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
  • Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
  • Maintain a valid driver's license with current auto liability insurance

OR

Social Worker

  • Master's degree from an accredited school of social work
  • Minimum 2 years' social work experience; 1-year case management or community-based social work preferred
  • Active NC license as a Licensed Clinical Social Worker (LCSW)
  • CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
  • Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
  • Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
  • Maintain a valid driver's license with current auto liability insurance

KSAOs

The ideal candidate will possess the following Knowledge, Skills, Abilities, and Other characteristics:

  • Computer skills required including various office software and the internet; experience with MS Office software preferred
  • Excellent communication skills - oral and written; Bilingual preferred
  • Knowledge of government, private sector, and community resources
  • Knowledge of Case Management principles
  • Knowledge of and compliance with federal and state regulations applicable to the position
  • Strong organizational and time management skills
  • Skills in establishing rapport with a member and applying techniques of assessing comprehensive health care needs
  • Critical thinking skills, effective clinical judgment, independent decision-making, and problem-solving abilities
  • Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels
  • Ability to work independently and function as an integral part of a multi-disciplinary team
  • Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
  • Able to shift strategy or approach in response to the demands of a situation

Working Conditions

  • The job environment is primarily an office or home environment
  • Multiple contacts, face-to-face and/or telephonic, are required with various members, providers, multi-payer systems, and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur
  • Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
  • Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices
  • Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
  • Travel will be required within the region and/or the State

Salary Estimate

The estimated salary range for this position is $60,000 - $80,000 annually, depending on qualifications and experience.

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