CARE NAVIGATOR (REMOTE)

JOB DETAILS

RESPONSIBILITIES

Conducts telephonic outreach to members to perform initial and annual Health Risk Assessments (HRAs) and develops an Individualized Care Plan (ICP) with member/caregiver.
Documents HRA information in the care management system during the phone call with the member and/or caregiver and documents all corresponding information or notes per department policy.
As part of the Health Risk Assessment, addresses identified health interventions or quality initiatives.
Encourages and provides assistance to members who may encounter obstacles to seeking care.
Uses pre-defined criteria to refer cases to care management based on HRA responses. Referrals made to internal resources or Provider Organization Care Management Programs as needed.
Utilizes department desktop procedures, workflows, job aids and training material. Identifies barriers to work processes and brings to the attention of the supervisor/manager.
Maintains the member‘s right to privacy and protects the company’s operations by keeping information confidential.
Adheres to all quality, compliance and regulatory standards.
Actively supports the achievement of the company’s Vision and Goals.
Contributes to team effort by accomplishing related results as needed.

REQUIREMENTS

High School Diploma or equivalent required
Bachelor’s Degree preferred
2 years of customer service experience, or related healthcare experience required.
Demonstrated knowledge of assessment, health and functional problems of older adults and managed care.
Bilingual English/Spanish required. Verbal score 3 or better, Written Score 3 or better.
Strong organizational skills.
Strong interpersonal skills, as well as strong written and verbal communication skills.
Ability to multitask and work with limited supervision.
Ability to provide professional customer service.
Ability to appropriately maintain confidentiality.
Ability to work well in a fast-paced and dynamic environment.
Proficient in MS Office.
Medical Assistant License preferred but not required

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Call: (424) 488-2577

Email: [email protected]