Care Management Navigator-PRN
Centra Health•Lynchburg, VA
•$29 - $42
About The Position
The Care Management Navigator acts as a point of contact within the Care Management Team, helping members access and navigate the healthcare system effectively. The role supports members with coverage and resource education, advocacy, care navigation, appointment and accessibility escalations, and coordination of approved variances. The Navigator also collaborates with the medical care team and the broader Centra system to identify member needs and follow-up priorities.
Requirements
- Bachelor’s degree in a healthcare-related field.
- Three years of experience in managed care, including appeals/grievance, claims, and member support roles.
Responsibilities
- Serve as the variance coordinator for the Care Management Team.
- Coordinate with the variance committee as needed.
- Assist with member escalations regarding appointments and accessibility.
- Provide members with education about coverage, navigation, and resources.
- Advocate for members to support informed decision-making.
- Guide members through the healthcare system.
- Collaborate with team members and the broader Centra system as needed.
- Work with the TPA for members granted variances to help prevent delays in care and claims errors.
- Promote informed decision-making among members.
- Assist the medical care team in identifying members and needs, setting priorities, and identifying problems requiring follow-up or further medical referrals.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
