Care Navigator

Job Title: Care Navigator

Location: Remote

Shift: 86:30 CST pm. We have 4 different shifts: 8:305 95:30 9:306 10: 6:30

Lunch break: 1 hour during training once assigned shift 30 minutes & 2 15minute breaks.

Duration: 8 months (Possible Extensions)

Summary:

• Provide support to medical behavioral and social support staff to determine needs eligibility and services for members.
• Conduct screening and risk assessment interventions per program guidelines.

Walk me through the daytoday responsibilities of this the role and a description of the project (Outside of Workday JD):

• These positions work in a Call Center setting where the contractors are on a phone queue
• Day to Day responsibilities Inbound call center assist and educate Medicaid members on benefits and Services such as PCP Changes ID Cards and Coordinate transportation and other services.
• Describe the performance expectations/metrics for this individual and their team:
• Adherence 90% or above
• Quality 95% or above
• Tell me about what their first day looks like:
• Day 1/week 1: Issued password badging laptop equipment ensure systems access and will start University training throughout the first week.
• Training: After week 1 will be set up with trainer for daytoday visibility into role
• What previous job titles or background work will be in this role
• Call center and medical insurance background (another MCO)

Job Responsibilities:

• Identify special needs members through the completion of health screens and other resources.
• Work with community outreach/member advocates to coordinate member care.
• Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes.
• Conduct site visits as appropriate for programs and provide support to other special programs.
• Assist with modification and management of care plans under the direction of a Registered Nurse in conjunction with member medical consenter or caregiver Department of Family and Protective Services (DFPS) caseworker and family if applicable as well as the managing physician.

Education/Experience:

• Bachelors degree in Social Work Health Services Behavioral Science or related field or equivalent experience. 02 years of experience