Care Navigator

Care Navigator

Elderwood IPA is seeking a Care Navigator to join our incredible growing team of professionals!

Why should you join Elderwood IPA?

Monday-Friday Schedule w/ no weekends or overnights

Medical, Dental & Vision upon 1st of month following 60 days of hire

Up to 140 hours (19 days) of PTO time PLUS six (6) holidays within the 1st year

401(k) retirement plan with vested employer match up to 4%

Substantial Referral program

Reporting to the Manager of Care Services, the Care navigator assists the clinical staff with case management responsibilities. These include speaking with clients or providers, Electronic Medical Record (EMR) documentation, ordering and managing client supply requests, and performing audits.

Responsibilities

• Assisting with outreach to medical providers for needed documentation or setting up appointments.
• Answering incoming calls and assisting with member questions and identifying when the call needs to be routed to a care manager.
• Completing call audits
• Coordinating and managing all incontinence supply requests
• Uploading Documents into EMR as needed and assist with mailings.
• Assists in monitoring member satisfaction through phone calls to verify service, answering questions and providing information. Documents member service issues, identifies trends and recommends potential solutions.
• Participates in interdisciplinary team meetings and provides input on customer service-related activities. Works within the interdisciplinary care team to support timely communication of member issues or needs and monitors screening of members effectively to improve quality and cost outcomes.
• Understands the organization's quality management program and the care coordinator's role within that program, with compliance of all policies and procedures.
• Maintains privacy, as per policies and procedures within a secure environment of documentation and communication.
• Contemporaneously and accurately documents phone conversations in designated PHI system.
• Embraces change; maintains an open mind and is flexible and adaptable in the face of ambiguity and change.
• May perform other duties or projects, as needed, to meet the needs of the business.

Qualifications

• Minimum of associate degree or equivalent work experience
• Demonstrated knowledge of Medicaid product information
• Basic understanding of health diagnoses and verbiage
• Demonstrated proficiency with Microsoft Office
• Experience within the insurance field preferred
• Experience with geriatric or Medicaid populations preferred
• Bilingual English/Spanish speaking preferred

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.