Care Navigator

Sevita • Gastonia, NC

3d

About The Position

The Care Navigator works in conjunction with the Care Manager to deliver integrated, whole-person care management for members with physical health, behavioral health, intellectual or developmental disabilities (I/DD), traumatic brain injury (TBI), long-term services and supports (LTSS), pharmacy, or unmet health-related resource needs. The role provides services in accordance with state and company care management requirements.

The Care Navigator supports members and their families or guardians through outreach, engagement, follow-up, coordination, referrals, and assistance accessing community-based resources and social support services. Member interactions may take place by telephone, virtually, or through in-home visits as required. The position maintains accurate electronic records of interactions and communicates relevant information to the Care Manager and care team. It also participates in case conferences, planning meetings, training, and quality improvement activities.

The position requires a high degree of quality and autonomy, travel as needed, and the ability to meet the specified light-work physical demands. There are no supervisory responsibilities.

Requirements

• Must be at least 18 years old.
• High school diploma or GED equivalent.
• Must satisfy one of the following experience pathways: lived experience with I/DD or TBI and demonstrated knowledge of and direct personal experience navigating the North Carolina Medicaid delivery system; parent or guardian of an individual with I/DD or TBI with at least two years of direct experience providing care for and navigating the Medicaid delivery system on that individual's behalf; or two years of paid experience performing functions in this job description, including at least one year of paid experience working directly with the Tailored Care Management eligible population.
• A parent or guardian cannot serve as an extender for their family member.
• Must meet all agency pre-employment requirements and requirements set by the state.
• Ability to perform work with a high degree of quality and autonomy.
• Travel as needed.

Nice To Haves

• Training in Tailored Care Management is preferred.

Responsibilities

• Support Care Managers in delivering care management.
• Engage members and their families or guardians professionally, compassionately, respectfully, and without judgment through telephone, virtual, and required in-home methods.
• Establish professional rapport with team members, stakeholders, peers, and supervisors.
• Initiate first contact with the member, family, or guardian to complete the preliminary questionnaire.
• Communicate information concerning member care and well-being to the Case Manager.
• Provide the Care Manager with documentation of billable events that aligns with minimum contact expectations.
• Maintain accurate, up-to-date electronic records of interactions, encounters, activities, and communications with members and their families or guardians.
• Conduct outreach, engagement, and follow-up to encourage members to accomplish goals in the Plan/ISP.
• Coordinate services and appointments.
• Conduct health promotion activities and share knowledge.
• Share information about members’ circumstances with the Care Manager and other care team members.
• Provide and track referrals, and help members obtain and maintain community-based resources and social support services.
• Participate in case conferences and planning meetings.
• Assist the Care Manager in proactively identifying and addressing service barriers, service gaps, and unmet health-related needs, and expand relationships and linkages to help meet members’ needs.
• Provide services that meet national, state, and local healthcare standards.
• Report concerns, general departmental activities, and staffing needs to the Care Manager.
• Complete required training and participate in educational sessions to improve skills.
• Attend industry meetings, training, and functions to promote positive stakeholder relationships.
• Participate in quality improvement and measurement activities to achieve identified targets and outcomes.
• Perform other related duties and activities as required.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED