Healthcare Navigation Specialist
2 weeks ago
Location
Administrative Office - Los Angeles, CA
Remote Work
Hybrid
Employment Type
Full Time
Educational Requirement
Associate's Degree
Compensation
$25.00 Hourly
Travel Requirements
None
Work Schedule
Day Shift
Job Sector
Healthcare
Position Summary
The Healthcare Navigation Specialist plays a crucial role in care coordination within the expanded Care Team and Care Management framework. This position is tasked with delivering short-term services in alignment with care plans for referred clients/patients, focusing on the utilization and follow-up of external community resources and specialty referrals. The Specialist oversees designated cases, coordinates healthcare benefits, educates patients, and facilitates timely and cost-effective access to care for our members. Collaboration and communication with patients, family members, providers, and other stakeholders are essential to promote wellness and empower members while ensuring access to appropriate services and maximizing benefits.
The Specialist actively participates as a member of the interdisciplinary team, serving as a liaison with various departments and external health and social service providers. This role also addresses the social needs of patients and members identified during screenings or care management services provided by registered nurses.
As part of the Care Management Program, the Specialist may assist with additional care coordination initiatives as directed by the Director of Performance Improvement. This includes managing the Remote Patient Monitoring (RPM) Program, which involves monitoring the distribution of RPM equipment, providing education on its use, and coordinating the overall implementation of the program. Additionally, the Specialist will coordinate care for Annual Wellness Visits (AWV) for Medicare or MediCal beneficiaries, including outreach and appointment scheduling.
Care coordination by the Specialist is vital to the clinic's care team, supporting and guiding patients and families through the healthcare system. This role acts as a communication bridge to understand individual patient needs, preferences, and concerns, collaborating with the core care team and external service providers, including community organizations, to ensure coordinated care.
Key Responsibilities
Care Navigation
- Assist the Care Team by:
- Connecting patients to social support services such as transportation, food resources, and housing assistance.
- Facilitating access to specialty services, including providing referral information and assistance with scheduling.
Documenting in the Electronic Health Record (EHR) to maintain integrated communication with the Care Team.Participating in team huddles to ensure effective communication.Conducting health assessments to develop informed Health Action Plans that address physical health, mental health, and social support needs.Ensuring the implementation of Health Action Plans related to care navigation and coordination.Utilizing motivational interviewing and trauma-informed care practices in patient interactions.
Remote Patient Monitoring Program
- Administering the RPM program for chronic care management.
- Monitoring and reporting on the distribution of RPM equipment.
- Providing education on the use and care of RPM equipment.
Care Coordination for AWV
- Conducting outreach and scheduling AWV appointments for Medicare beneficiaries.
- Coordinating referrals for Chronic Care Management services.
Quality Improvement and Assurance
- Participating in quality improvement and assurance activities as assigned.
Other Duties
- Performing any additional responsibilities as assigned by the CEO or Director of Performance Improvement.
Qualifications
Experience
- Required:
- Associate's or Bachelor's degree.
- Additional relevant work experience may be considered in lieu of a degree.
- Preferred:
- Experience in case management or care coordination for underserved populations.
- Required:
- Ability to work effectively with diverse populations.
- Strong interpersonal skills to connect and engage with individuals.
- Critical thinking and effective communication skills for consulting with members and providers.
- Proficiency in using a personal computer for documentation.
- Preferred:
- Knowledge of motivational interviewing techniques.
- Familiarity with clinical standards of care and community resources.
- Bilingual proficiency in one of LA County's Medi-Cal threshold languages is highly desirable.
- Legal authorization to work in the United States.
- A valid California Driver's license with a clean record and access to an insured vehicle.
- Completion of necessary health assessments and background checks.
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