Care Navigator
Care Navigator
Posted on :
20-10-2024
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Job Description
Job Description:
Job Title: Care Navigator
Location: Remote
Hours of operation: 8:30am5:00pm CST no overtime required
Duration: 3 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.
Skills/Experience:
- MedicalLong Term Services and Supports Background Working with the Aging Blind and Disabled Background in Managed Care
- MCO Medicaid STARPLUS insurance knowledge
- Call center experience is a must worker is expected to be on the phones for the shift and will need to follow their schedule timely
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 Centene 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 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
Employment Type
Full Time
Key Skills
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