Care Coordination Specialist
4 days ago
Navvis is a pioneering healthcare company that revolutionizes population health management. Our innovative approach focuses on delivering Real-Person Care, a transformative approach that responds to the unique needs of individuals. We partner with health plans, health systems, providers, and employers to eliminate barriers and siloed efforts that fragment care.
Job OverviewAs a Care Coordination Specialist at Navvis, you will play a vital role in ensuring seamless care coordination and delivery. You will work collaboratively with the multidisciplinary healthcare team, providers, and patients to engage patients in their care plans and ensure the completion of quality measures. Your primary responsibility will be to facilitate patient care, including scheduling, gaps in care closure, and data entry into our designated care management module.
Responsibilities- Facilitate patient care, including scheduling, gaps in care closure, and data entry into our designated care management module.
- Generate and receive calls from patients and providers to coordinate services and satisfy high-risk member needs.
- Provide support to the RN Care Manager in administrative tasks related to referrals of high-risk members to other Health Management Programs, services, and community resources.
- Report any possible issues related to member healthcare to the appropriate stakeholder, such as the Nurse or other member of the multidisciplinary healthcare team, in a timely manner.
- Provide monitoring and outreach as indicated for members who may need gap in care closure, annual HRA, or monitoring for a change in condition/status.
- Document all calls, outreach attempts, interventions, activities, and any additional information in the appropriate electronic tool and/or platform.
- Facilitate chart/record submission, portal data entry, and supplemental data submission to various payers as required.
- Assist with Care Navigation.
- Complete proactive outreach and engagement for patients with open care gaps to assist with care gap closure.
- Generate reports as required.
- Work in compliance with federal, state, and local regulations that apply to all lines of business population.
- Comply with all assigned organizational performance and quality metrics.
- High School diploma required; some college preferred.
- 2+ years of healthcare customer service or call center experience preferred.
- Medical Assistant with call center experience desired.
- Medical Terminology desired.
- Excellent customer service skills.
- Knowledge of population health a plus.
- Bilingual a plus.
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