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Healthcare Navigator

2 weeks ago

Dallas, Texas, United States Rightway Inc Full time

Rightway Inc is a company that harmonizes healthcare for everyone, everywhere. Our mission is to guide members to the best care and medications by inserting clinicians and pharmacists into a member's care journey through a modern, mobile app.

About the Role

The Clinical Care Coordinator RN performs clinical triage, high-risk outreach, condition support, care planning, clinical education, and care coordination functions in supporting Rightway members with navigating, accessing, and best supporting their care needs.

This role serves as a trusted advisor for providing clinical guidance and directing to the most appropriate high-quality care providers with the objective of improving clinical outcomes while also reducing healthcare costs.

Responsibilities
  • Clinical triage to assess the severity of the member's health concerns using evidence-based protocols and algorithms in directing care to the right healthcare resource in a timely manner without compromising quality or safety
  • Leveraging data-driven analytics in conducting proactive outreach to engage members of clinical interest, e.g. high-risk, high-spend, rising risk, and evidence of care gaps with the objective of engaging and assisting members in making more informed care decisions, supporting across their continuum of care and well-being journey with lifestyle and behavior changes
  • Engage members in clinical conversations to best understand their care needs, assess risks, preferences, and care barriers, and then guide and recommend appropriate next steps to improve health outcomes
  • Identify and address barriers preventing members from accessing preventative care or establishing ongoing relationships with primary care providers
  • Assist in scheduling appointments, referrals, and follow-up care to close gaps in preventative care and chronic disease support