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