Care Navigator

3 days ago

Poughkeepsie, New York, United States Access Full time
Care Navigator Job Description

At Access, we are seeking a highly skilled Care Navigator to join our team. As a Care Navigator, you will play a critical role in promoting effective connection and collaboration to services, removing barriers to care, and navigating individuals through healthcare services, insurance plans, and systems.

Key Responsibilities:
  • Coordinate care to improve quality of care through the efficient use of resources and enhance quality, cost-effective outcomes.
  • Act as an advocate and assist in coordination of care to minimize the fragmentation of healthcare delivery systems.
  • Gather insurance information and assist in navigating complex healthcare and insurance systems.
  • Assist in securing health insurance and complete referrals to care management services and other internal and external services as needed.
  • Identify and effectively utilize community resources to meet the needs of the member/family and facilitate access to community resources.
  • Collaborate with providers and other healthcare team members to facilitate care across the healthcare continuum and optimize clinical and financial outcomes.
  • Maintain a working knowledge of payer requirements and negotiate on behalf of the member for cost-effective, high-quality services.
  • Serve as a liaison to providers, members, and families for coordination of services and document all interventions using the Complex Care Management billable documentation.
Requirements:
  • Excellent written, verbal, and listening abilities with the ability to communicate clearly and effectively to staff and providers.
  • Willingness to establish effective working relationships with internal and external providers/resources and maintain a good working relationship within the department and with other departments.
  • Ability to manage conflict, stress, and multiple simultaneous work demands in an effective and professional manner.
  • Ability to work well independently while collaborating with other team members and adapt to changing program or organizational priorities.
  • Ability to make independent decisions in accordance with established policies and procedures.
  • Knowledge of and appreciation for cultural diversity and low literacy issues in care provision.
  • Computer literacy with the ability to navigate Electronic Health Records and other systems.
Education and Experience:
  • Bachelor's Degree in Health and Human Services or related field (major concentration in social work, psychology, nursing, rehabilitation, education, occupational therapy, physical therapy, recreation or recreation therapy, counseling, community mental health, child and family studies, sociology, speech and hearing or other human services field) or NYS licensure and registration as a Registered Nurse and a bachelor's degree or Bachelor's level education or higher in any field with five years of experience working directly with highly vulnerable populations.
  • Bilingual English and Spanish speaking preferred.
  • Two years of experience in linking individuals with SMI, Developmental Disabilities, or alcoholism or substance abuse to a broad range of services essential to successful living in a community setting.

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