Clinical Support Navigator
2 weeks ago
Position Overview:
The role of the Care Navigator involves the development, assessment, and coordination of care management activities tailored to the needs of members, ensuring the delivery of quality and cost-effective healthcare outcomes. This position is pivotal in crafting personalized care plans and educating members along with their families or caregivers about available services and benefits, thereby enhancing healthcare access and ensuring high-quality care through effective advocacy and coordination.
Key Responsibilities:
- Evaluate member needs, identify barriers to care, and recommend appropriate resources to facilitate optimal outcomes.
- Collaborate in the creation of personalized care plans and identify necessary providers, specialists, and community resources.
- Offer psychosocial support and resource guidance to members and caregivers, assisting them in accessing local services such as employment, education, and housing.
- Ensure effective communication between members, families, and the care provider team to guarantee timely access to services.
- Monitor progress towards care plan goals and collaborate with healthcare providers for necessary revisions.
- Maintain comprehensive documentation of member information and care management activities to comply with regulatory standards.
- Conduct on-site assessments as needed and provide educational support to care managers and members regarding healthcare procedures and benefits.
Qualifications:
- A Bachelor's degree is required, along with 2 to 4 years of relevant experience. Candidates with clinical licensure must have graduated from an accredited nursing program.
- Preferred qualifications include experience in managed care and a background in serving the aging, blind, and disabled populations.
- Strong customer service skills are essential, and bilingual candidates are preferred.
Performance Metrics:
- Adherence to guidelines should be 90% or above.
- Quality of service should meet or exceed 95%.
Training and Development:
- New hires will receive comprehensive training, including system access setup and client university training during the initial week.
Additional Information:
- Candidates should be prepared for a dynamic work environment where they will interface with various internal and external groups.
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