Care Navigator

Centene Corporation•Remote-OH, OH

3d•$23 - $39

About The Position

The Care Navigator develops, assesses, and coordinates care management activities based on member needs to support quality, cost-effective healthcare outcomes. The role develops or contributes to personalized care plans and educates members and their families or caregivers about services and benefit options to improve access to care and support appropriate, high-quality care through advocacy and coordination. This is a field-based position. Applicants must reside in Montgomery County, Ohio, or a surrounding county: Butler, Warren, Greene, Clinton, Clark, Miami, Darke, Hamilton, Clermont, Brown, Highland, Fayette, Madison, Champaign, or Shelby. The schedule is Monday through Friday, 8:00 AM to 5:00 PM. The ideal candidate has strong communication and customer service skills, experience working with multidisciplinary teams, problem-solving ability, computer proficiency, organizational and time-management skills, and the ability to work independently. The role requires a bachelor’s degree and 2–4 years of related experience. Candidates holding clinical licensure must be graduates of an accredited school of nursing. Equivalent experience demonstrated through applicable knowledge, duties, scope, and skills may also qualify. A current state clinical license is preferred.

Requirements

Bachelor’s degree and 2–4 years of related experience.
If holding clinical licensure, graduation from an accredited school of nursing is required.
Equivalent experience acquired through applicable knowledge, duties, scope, and skills may qualify.
Strong communication and customer service skills.
Experience working with multidisciplinary teams.
Strong problem-solving abilities.
Computer proficiency.
Effective organizational and time-management skills.
Ability to work independently as a self-starter.
Applicants must reside in Montgomery County, Ohio, or one of the listed surrounding counties.
Work Monday through Friday, 8:00 AM to 5:00 PM.

Nice To Haves

Current state clinical license preferred.

Responsibilities

Evaluate member needs, barriers to care, and available resources; recommend and facilitate a plan to achieve the best outcome.
Develop or contribute to personalized and ongoing care plans or service plans, and identify providers, specialists, and community resources needed for care.
Provide psychosocial and resource support to members, caregivers, and care managers to access local resources or services based on assessments and plans.
Coordinate between members or their families and caregivers and the care provider team to ensure identified care and services are accessible in a timely manner.
Monitor progress toward care plan or service plan goals and member status or changes in condition, as applicable; collaborate with healthcare providers on plan revisions or identified needs and refer to care management for further evaluation as appropriate.
Collect, document, and maintain member information and care management activity records to ensure compliance with applicable state, federal, and third-party payer requirements.
Perform on-site visits to assess member needs and collaborate with providers or resources, as appropriate.
Educate care managers, members, and their families or caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits, as applicable.
Perform other duties or responsibilities as assigned to meet member or business needs.
Comply with all policies and standards.