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Patient Care Navigator
2 months ago
Importance of This Role: The Care Coordinator plays a vital role in the care management team, directly assisting assigned members in navigating 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, fostering trust and responsiveness to their concerns.
The Care Coordinator is tasked with aiding members in developing a personalized care plan and connecting them with a comprehensive support network to help achieve their goals for independent living, recovery, and community engagement.
This role necessitates in-person visits to members' residences and supports individuals across various locations.Supervision Responsibilities: + This position does not have direct reports.
Key Responsibilities:
+ Maintain open communication channels with members, interacting as needed 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 their care management. + Convene the ICT for each member at least once a year and as required. + Ensure that members possess a current and individualized care plan. + Support members during transitions of care, both before and after discharge. + Assist members in submitting service requests. + Review quality gap reports during each visit; work with the care team and primary care provider to address these gaps. + Conduct joint visits with other care team members as appropriate to manage complex care needs. + Document interactions using a Certified Enrollee Record, adhering strictly to organizational policies and procedures. + Leverage internal resources to ensure timely implementation of care plans. + Provide outreach to members through telehealth technologies (video, chat, etc.) as appropriate for care management services. + Actively participate 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 necessary. + Address team needs at the discretion of the Clinical Manager (e.g., providing intermittent support during 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 required. + A valid driver's license with no restrictions is necessary.
Ability to remain active and mobile within the assigned state.
Qualifications:
Required Education:
+ Associate's degree or clinical license (e.g., LPN, Medical Assistant)
Preferred Education:
+ Bachelor's degree
Preferred Licensing:
+ Clinical license (e.g., LPN, Medical Assistant) if an Associate's degree is not held.
Required Experience:
+ 1-2 years of experience caring for patients/members with complex medical, behavioral health, and social needs.
Preferred Experience:
+ 5+ years of experience in healthcare. + Experience with a Medicare Advantage population is preferred.
- Experience with Substance Use Disorders
Essential Knowledge, Skills & Abilities:
+ Experience in a customer-facing role. + Strong communication skills. + Conflict management skills. + Organizational abilities.
Required Language(s):
+ English
Preferred Language(s):
+ Bilingual preferred.
Equal Opportunity Employer. Employment is contingent upon acceptable professional references, background checks, and verification of qualifications.
