Care Navigator - UM

P3 Health Partners • Henderson, NV

1d • Hybrid

About The Position

Under the supervision of the Medical Management Nurses, this position is responsible for assisting the nurses with Medical Management processes that do not require RN intervention, based on the scope of practice within the state. Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.

Requirements

• High School graduate required
• Strong problem-solving skills required
• Knowledge of medical terminology required
• Excellent communication skills with patients, providers, internal and external customers required
• Must have excellent computer skills
• Must have excellent organizational skills and ability to work independently
• Friendly and compassionate disposition
• Proficiency with computer, software programs (i.e. Microsoft Word, Excel) and internet required
• Excellent communication and problem-solving skills
• Excellent organizational and time management skills
• Ability to learn quickly
• Ability to handle a fast-paced environment and prioritize tasks based on importance
• Strong interpersonal communication skills
• Ability to work independently or as part of a team
• Dedication to maintaining confidentiality of all patient records
• Knowledge of medical terminology required Ability to demonstrate knowledge of vital signs and other clinical skills to obtain and maintain employment
• Familiarity with EMR’s

Nice To Haves

• Education as a medical assistant or nursing school student helpful
• Experience in a managed care organization preferred

Responsibilities

• Assists Medical Management team in gathering additional clinical information when applicable
• Responsible for timely and accurate documentation in systems
• Develops spreadsheets and other tools to support Medical Management team
• Create prior authorizations from incoming portal entrees and faxes
• Outreach to facilities to follow up on member's discharge
• Verify eligibility
• Promote the mission, vision and values of P3 Health Partners

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees