Patient Care Navigator
2 weeks ago
Importance of This Role: The Care Coordinator plays a crucial role in the care management team, working closely with assigned members to help them effectively navigate the healthcare landscape. This position ensures that members are informed about available services and addresses their inquiries regarding accessing necessary care. The Care Coordinator engages with members through their preferred communication methods, including in-person visits, to foster trust and ensure that their concerns are promptly addressed.
The Care Coordinator is tasked with aiding members in developing a personalized care plan and connecting them with a comprehensive support network within the care team to promote their goals for independent living, recovery, and community engagement.
This role necessitates in-person visits to members' residences and will involve supporting members across various locations.Supervision: + This position does not have direct reports.
Key Responsibilities:
+ Maintain open communication with members and interact based on their preferences and care plan recommendations. + Serve as the primary resource for members regarding their healthcare benefits. + Collaborate with community-based primary care providers and specialists as necessary. + Ensure that members have an interdisciplinary care team (ICT) that includes all key individuals involved in managing their care. + Convene the ICT for each member at least once a year and as needed. + Ensure that members possess a current and individualized care plan. + Support members during transitions of care, both pre and post-discharge. + Assist members with service requests. + Review quality gap reports during each visit; collaborate with the care team and primary care provider to address these gaps. + Conduct joint visits with other care team members as appropriate to meet complex care needs. + Document interactions using a Certified Enrollee Record, adhering strictly to organizational policies and procedures. + Utilize internal resources to ensure timely implementation of the care plan. + Provide outreach to members through telehealth technologies (video, chat, etc.) as appropriate for care management services. + Participate actively in organizational projects and initiatives throughout the year. + Support local team training or clinical seminars as needed. + Assist leadership in developing, refining, and enhancing programs, processes, policies, workflows, and projects. + Mentor new care coordinators during and beyond their orientation period, if required. + Address team needs at the discretion of the Clinical Manager (e.g., providing intermittent support with team meetings or communicating updates to staff). + Serve as a role model for peers and support team members through changes, exemplifying the organization's mission and model of care.
Working Conditions:
+ Work settings include residential and community environments. + Must be willing and able to travel to members' homes and work in the local office as needed. + A valid driver's license with no restrictions is required. + Ability to remain active and mobile across the assigned state.
Qualifications:
Required Education:
+ Associate's degree or clinical license (e.g., LPN, Medical Assistant)
Desired Education:
+ Bachelor's degree
Desired Licensing:
+ Clinical license (e.g., LPN, Medical Assistant) if no Associate's degree
Required Experience:
+ 1-2 years of experience caring for patients/members with complex medical, behavioral health, and social needs.
Desired Experience:
+ 5+ years of experience in healthcare + Experience with a Medicare Advantage population is preferred.
- Experience with Substance Use Disorders
Required Knowledge, Skills & Abilities:
+ Experience in a customer-facing role + Strong communication skills + Conflict management skills + Organizational abilities
Required Language(s):
+ English
Desired Language(s):
+ Bilingual preferred.
EEO is The Law. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled. Please note that employment is contingent upon acceptable professional references, a background check, and verification of a valid clinical license if applicable.
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