Care Navigator - Remote in Colorado ONLY

Western Healthcare Alliance•Grand Junction, CO

4d•Remote

About The Position

The Care Navigator supports the Community Care Alliance care coordination program for assigned populations, including Medicare and Medicaid members, as part of an interdisciplinary team. The role organizes, collects, reviews, and reports health and social information through phone outreach, using culturally sensitive and effective communication. The Care Navigator follows organizational policies, payer requirements, scope of practice, and community safety protocols, and supports preventive and disease management programs. The position helps improve enrolled patients’ quality of life by supporting quality outcomes, facilitating care transitions, coordinating care across the health continuum, and encouraging healthy lifestyle choices. It provides culturally appropriate information about health and community resources to reduce barriers to care, and represents the organization while working with patients, clinics, referral sources, providers, and other constituents. The role is remote and limited to candidates in Colorado.

Requirements

Two years of progressive related experience working with diverse populations.
Knowledge of health education and motivational strategies, and an empathetic manner when working with underserved populations.
Ability to communicate effectively and demonstrate multicultural sensitivity when working with members.
Ability to work collaboratively as part of an interdisciplinary team and with clinics, providers, referral sources, and community partners.
Ability to organize, collect, review, report, and document health and social information.
Familiarity with Microsoft Teams, Excel, and Word.

Nice To Haves

Experience in a healthcare setting.
Bachelor’s degree in a related field and/or a related certification such as MA, CNA, or LPN; equivalent combination of education and experience enabling performance of the full scope of the position is also accepted.
Knowledge of healthcare business.
Knowledge of the local area.
Bilingual qualification; eligible employees receive an additional $2.00 per hour.

Responsibilities

Collaborate with the interdisciplinary team and clinic staff to support individualized care plans addressing physical, behavioral, and social needs, and provide education and recruitment support.
Apply the Seven Domains of Care Coordination: Population Health Management, Comprehensive Assessment and Care Planning, Interpersonal Communication, Education/Coaching, Health Insurance and Benefit Knowledge, Community Resource Knowledge, and Research and Evaluation Skills.
Provide outreach, disease management, education, and other clinically based activities for patients with chronic health conditions, referral sources, and the community.
Coordinate referrals to medical, behavioral health, social, environmental, and community-based resources to reduce barriers to care.
Conduct assessments and ongoing reassessments to identify changing health and social needs, and assess participants’ readiness, willingness, and ability to change.
Identify patient coaching, support, and education needs based on what matters to patients’ quality of life; connect them with relevant resources and provide tools that promote self-management.
Conduct health and wellness coaching to support lasting changes, monitor and document progress toward optimal wellness, and promote preventive care and education.
Serve as a liaison among referral sources, facilities, and outside entities to prevent or resolve continuity-of-care issues.
Coordinate with service delivery partners, providers, and other health professionals to help ensure plans of care use health care resources efficiently.
Coordinate and monitor care to promote quality and cost-effective outcomes.
Follow up proactively with patients discharged from hospitals, rehabilitation facilities, and emergency rooms; recruit them into care management services, help ensure provider appointments are scheduled, and review unmet needs before appointments.
Analyze clinical data from EHR and registry systems to identify care gaps and use risk stratification metrics to support care coordination recruitment.
Communicate issues requiring intervention to appropriate care team members, providers, and departments.
Assist clinics with billing questions related to services provided by the Regional Care Coordinator.
Stay current on industry trends, operational best practices, and changing patient and provider needs.
Collaborate across documentation platforms and use tools including Microsoft Teams, Excel, and Word.

Benefits

Medical insurance with low premium cost and multiple plan options.
Dental insurance through Delta Dental.
Vision insurance through VSP.
401(k) with 5% company match.
Flexible Spending Account for healthcare and dependent care expenses.
Seven paid holidays during the year.
Paid time off accruing at three weeks in the first year, four weeks after year five, and more each year thereafter.
Sick leave accruing up to six days each year.
Employer-paid life and long-term disability plans, with options to purchase additional coverage.
Employee Assistance Program for employees and household members.
Pet insurance.
Access to group discounts, including mobile phone and rental car discounts.