Patient Care Navigator
2 weeks ago
Importance of This Role:
The Care Coordinator plays a crucial role in the care management team, directly engaging with assigned members to facilitate their navigation through the healthcare landscape. This position ensures that members are well-informed about accessing services and addresses their inquiries regarding necessary care. The Care Coordinator utilizes various communication methods, including in-person interactions, to foster engagement, build trust, and respond promptly to member concerns.
In this role, the Care Coordinator assists members in developing a personalized care plan, connecting them with a comprehensive support network within the care team to help achieve their goals for independent living, recovery, and community involvement.
This position necessitates in-person visits to members' residences and offers support across diverse locations.Supervision Responsibilities:
+ This role does not include direct supervisory responsibilities.
Key Responsibilities:
+ Maintain open communication channels with members, interacting based on their preferences and care plan needs.
+ Serve as the primary resource for members regarding their healthcare benefits.
+ Collaborate with community-based primary care providers and specialists as necessary.
+ Ensure members have an interdisciplinary care team (ICT) consisting of all essential personnel involved in their care management.
+ Convene the ICT for each member at least once a year and as required.
+ Ensure members possess a current and individualized care plan.
+ Support members during transitions of care, both pre and post-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.
+ Utilize 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.
+ Participate actively in organizational projects and initiatives throughout the year.
+ Support local team training or clinical seminars as needed.
+ Assist leadership in developing and refining programs, processes, and workflows.
+ Mentor new care coordinators during their orientation and beyond, if necessary.
+ Support team needs at the discretion of the Clinical Manager, including facilitating team meetings or huddles and communicating updates to staff.
+ Act as a role model for peers, demonstrating the organization's mission and model of care during times of change.
Working Conditions:
+ Work environments include residential and community settings.
+ Must be willing 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 We Seek:
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 in healthcare, with a preference for experience with a Medicare Advantage population.
- Experience with Substance Use Disorders is a plus.
Essential Knowledge, Skills & Abilities:
+ Experience in a customer-facing role.
+ Strong communication and conflict management skills.
+ Excellent organizational abilities.
Required Language:
+ English
Preferred Language:
+ Bilingual candidates are preferred.
EEO is The Law. Equal Opportunity Employer for Minorities/Women/Protected Veterans/Disabled. Employment is contingent upon acceptable professional references, background checks, and verification of qualifications.
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