Critical Care Navigator

3 days ago


Dubuque, Iowa, United States Cottingham & Butler Full time
Job Description

Critical Care Specialist

Cottingham & Butler is seeking a highly skilled and compassionate Critical Care Specialist to join our Employee Benefits team. As a Critical Care Specialist, you will play a vital role in identifying and assessing individuals with serious conditions, exploring options for care and resources that will lower their out-of-pocket costs, and exploring risk transfer opportunities that can lower health plan costs.

Key Responsibilities:

  • Identify High-Risk Individuals: Collaborate with consultants, producers, carriers, TPAs, and reporting tools to identify individuals with large claims.
  • Client Communication: Communicate with client contacts to determine employee status and align on engagement strategies.
  • Strategy Execution: Execute strategies by working closely with individuals, employers, and benefits team members.
  • Resource Navigation: Assist individuals in understanding their diagnosis and guide them to high-value care facilities and alternative insurance options.
  • Carrier Navigation: Proactively contact carriers and service providers to navigate individual situations.
  • Outcome Measurement: Record outcomes based on client goals, measuring risk mitigation and transfers.

Requirements:

  • Education: Bachelor's Degree or Bachelor of Nursing preferred.
  • Experience: Minimum of three years in business. Ideally, two years of nursing experience or case management work.
  • Skills:
    • Oral and Written Communication: Proficient in professional communication across various formats.
    • Concierge-Level Service: Skilled in building trust and guiding individuals to necessary resources during critical times.
    • Project Management: Capable of managing multiple tasks and organizing projects to ensure successful outcomes.
    • Organizational Skills: Detail-oriented with the ability to track progress and prioritize tasks effectively to achieve results.
  • Specialized Knowledge:
    • Life & Health Insurance License: Obtain and maintain a Life & Health Insurance License.
    • Benefit Funding Mechanisms: Knowledge of benefit funding mechanisms, HIPAA, carrier networks, and service solutions.
    • Large Claim Conditions: Familiarity with conditions such as diabetes, ESRD, cancer, CAD, COPD, MS, gene therapy, and specialty medications.
    • Leave and Disability: Understand the impact of Family Medical Leave, other leave of absences, and disability on employee benefits.
    • Other Insurance Alternatives: Knowledge of alternative health insurance sources based on the individual's and employer's unique situations.
    • Business Acumen: Understand client culture and strategy.

About Cottingham & Butler:

Cottingham & Butler is a growth company that sells a promise to help our clients through life's toughest moments. We aim to hire, train, and grow the best professionals in the industry. We look for people with an insatiable desire to succeed, are committed to growing, and thrive on challenges. Our culture is guided by the theme of 'better every day' constantly pushing ourselves to be better than yesterday.



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