Care Navigator IPA

Elderwood•Buffalo, NY

3d•Onsite

About The Position

Elderwood IPA is seeking a Care Navigator to join our incredible growing team of professionals! This role involves managing incoming calls, documenting information, interacting with clients with various challenges, coordinating outreach to medical providers, and supporting the interdisciplinary care team. The Care Navigator will also handle office duties, monitor member satisfaction, and participate in team meetings, all while maintaining privacy and embracing change.

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.