Healthcare Navigator/ Targeted Case Manager (52894)

Westcare•Pikeville, KY

38d•Hybrid

About The Position

The Healthcare Navigator/ Targeted Case Manager is responsible for assisting potential program participants obtain medical insurance coverage, obtaining and maintaining prior authorizations, identifying community resources, maintaining appropriate timely documentation, and maintaining the electronic health record (EHR) of clients served. This role involves enrolling individuals into health insurance plans, tracking prior authorizations, connecting clients with community support services, and documenting all client interactions within the electronic medical record according to agency and Medicaid services standards. The position also requires maintaining consistent contact with clients, educating and referring them to applicable services, completing screenings and assessments, and traveling between locations to connect with clients. Data input into the EMR, report generation, and participation in performance improvement activities are also key aspects of the role. The Healthcare Navigator/ Targeted Case Manager is expected to embrace and embody the mission, vision, and guiding principles of WestCare Foundation and perform any other duties as assigned.

Requirements

Bachelors degree in Human services, Social Work or a related field is required.
Current Targeted Case Management certification Required.
Valid driver’s license and the ability to obtain and maintain WestCare’s vehicle insurance is required.
Graduation from an accredited four-year college with a degree in Human Services, Social Work, Psychology, or related focus area required.
High School Diploma or equivalent is required.
At least one (1) year of experience in a comparable role is required.
Proficiency in Microsoft Word, Excel, Outlook, and Office required.
Familiarity with and knowledge of area resources required.
Basic understanding of appropriate documentation required.
Ability to work with multi-disciplinary teams required.
Ability to organize, handle multiple responsibilities, and prioritize appropriately.
Ability to communicate accurately and responsibly with internal and external teams.
Ability to work collaboratively with others in a manner that is pleasant and professional.
Ability to work well, both individually and as part of a team.
Excellent verbal and written communication skills.

Responsibilities

Helps enroll or reenroll eligible individuals into health insurance plans including Medicaid across multiple programs.
Assists in obtaining and tracking prior authorization’s for services.
Locates and connects clients with community assistance support services to help achieve their goals and meet basic needs.
Documents each client encounter within the electronic medical record.
Maintains adherence to the documentation timelines of WCKY and all associated oversight bodies or agencies.
Maintain consistent contact with clients, as defined by agency and department of Medicaid services standards.
Educates and refers potential program participants to applicable services both internal and external.
Completes screenings and assessments of potential program participants.
Travel between, WCKY program’s connecting with new and transitioning clients in order to connect them with services.
Input data into the EMR including demographics, insurance information, authorization information, treatment plans, treatment plan reviews, case notes for each encounter, assessments, and follow up appointments.
Produces reports for the Program Director and Operations Manager as needed.
Provides feedback to the Program Director and the Operations Manager regarding attainment of goals and objective as well as data collection.
Assists area and programmatic leadership in Performance Improvement activities.
Assists other WestCare staff as needed to promote cooperation and portray a professional image to the community.
Embraces and embodies the mission, vision, guiding principles, clinical vision and goals of WestCare Foundation.
Performs any other duties as assigned.