Health Navigator

3 weeks ago


National City, California, United States OPSAM Health Full time
Job Title: Health Navigator

At OPSAM Health, we are seeking a highly skilled Health Navigator to join our team. As a Health Navigator, you will play a critical role in ensuring compliance with health plan requirements and improving member relationships and preventative care outcomes.

Job Summary:

The Health Navigator will coordinate with health plans to ensure compliance issues are addressed, prepare reports on HEDIS measures, and communicate results to stakeholders. This role requires strong organizational skills, attention to detail, and effective communication skills.

Key Responsibilities:
  • Comply with department policy and procedures
  • Obtain needed data from health plans regarding HEDIS measures
  • Collect medical records, conduct reviews, and ensure accuracy of documentation for reporting
  • Assist in planning and implementation of projects to improve delivery of services and quality of care
  • Perform patient outreach and scheduling to close care gaps
  • Understand the principles of HEDIS and HIPAA
  • Provide in-service training to providers regarding HEDIS and CMS Star Measures
  • Generate and maintain accurate reports as required
  • Attend to health plan, provider, and interdepartmental calls
Requirements:
  • Bachelor's degree in Public Health, Health Education, Social Work, or closely related field
  • One year of experience providing medical information and dissemination
  • Reliable transportation, clean driving record, and car insurance
Working Conditions:

The Health Navigator will work in a fast-paced environment, requiring strong organizational skills and attention to detail. The role involves frequent communication with health plans, providers, and stakeholders, as well as travel to clinics and community settings.


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