Care Navigator

Elderwood/Pediatric/PostAcute/Woodmark•Buffalo, NY

13d•$18

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 Reporting to the Manager of Clinical Operations, 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.

Requirements

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

Nice To Haves

Experience within the insurance field preferred
Experience with geriatric or Medicaid populations preferred
Bilingual English/Spanish speaking preferred

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.