Care Navigator IPA
About The Position
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 Care Navigator Overview Reporting to the Manager, Social Work, the incumbent 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.
Requirements
- Minimum of High School Diploma
- 1 – 3 years of experience within the medical insurance field, (specifically with geriatric or Medicaid populations preferred), knowledge of Medicaid product information, and basic understanding of health diagnoses and verbiage
- Demonstrated proficiency with Microsoft Office
Nice To Haves
- Bilingual English/Spanish speaking preferred
Responsibilities
- Answer, follow script, and simultaneously document incoming calls in the designated Health Protected Information (HPI) system.
- Providing an answer or information to member questions and whether to route calls to a Care Manager.
- Able to successfully interact with clients who have cognitive, mental health, or social challenges.
- Responsible for completing assigned outreach to medical providers to obtain required documentation or to set appointments for clients.
- 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.
- Coordinate and manage all client supply requests.
- Office duties including the uploading documents into EMR, assisting with US postal mailings, and other duties
- Monitor member satisfaction through auditing service phone calls (ensuring the staff members are supportive of the caller, can answer their questions and provide information, or routed the call appropriately).
- Document identified service issues, identifying trends, and make recommendations to resolve issues.
- Participates in interdisciplinary team meetings and provides input on customer service-related activities.
- 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.
- Embraces change; maintains an open mind and is flexible and adaptable in the face of ambiguity and change.
Benefits
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
