Insurance Navigator/Ongoing Care Coordinator

ElevaCare•Worthington, MN

About The Position

This dual position provides ongoing care coordination and insurance navigation to help connect the public and service agencies with ElevaCare clinical services. The role uses available data, technology, and client-centered skills to coordinate behavioral and physical health-care needs for individuals, families, and children throughout their treatment experience. It helps clients find and access appropriate health-care services, community resources, and insurance options, while monitoring intake, referrals, education, and treatment-plan reviews so clients understand their current and recommended services and can participate in their treatment. The position works with internal and external providers to coordinate client health needs. It applies motivational and client-centered approaches, problem-solving, and knowledge of ElevaCare and community resources to help clients achieve health goals and quality of life. The role manages a caseload, supports communication among clients, staff, providers, and family members, and contributes to care planning, follow-up, and transitions between services. The position requires office and computer skills, including Microsoft Office, Windows, electronic health records, billing software, and basic computer peripherals. Work involves travel among ElevaCare facilities in the catchment area, possible exposure to communicable diseases and varying weather or damp conditions, and physical activity including standing, walking, reaching, bending, kneeling, and occasionally lifting up to 40 pounds. Evening and weekend work may be required based on Center needs.

Requirements

Two-year technical college diploma or equivalent education and experience preferred.
Experience using or ability to use office equipment and technology.
Strong verbal, written, organizational, and interpersonal skills.
Knowledge of Microsoft Office Suite and basic operations in the Windows operating system.
Knowledge of electronic health records and billing-services software programs.
Basic knowledge of personal computers, laptops, printers, and scanners.
Ability to read, write, speak, apply mathematical concepts, and use sound reasoning to perform job duties.
Problem-solving and critical-thinking skills, and ability to multitask.
Ability to perform the essential functions, including required hours and travel to ElevaCare facilities in the catchment area.
Ability to maintain confidentiality, work effectively in a team, and comply with safety principles, laws, regulations, and standards.

Responsibilities

Follow front-desk protocols, triage calls for first-time appointment scheduling, collect background information, and maintain contact with referral sources to support linkage to services.
Complete admission forms, obtain required signatures and releases of information, and request and file background information from outside organizations.
Help clients find and access appropriate health-care services, community resources, and insurance options.
Inform clients of their rights, responsibilities, and data-privacy practices; obtain and update demographic, insurance, and billing information.
Assess client risk using the CSSRS brief and determine whether routine, urgent, or crisis services are needed.
Review appointment attendance and follow scheduling procedures for therapy, psychiatry, and substance-use services.
Assist walk-in clients in connecting with ElevaCare services.
Provide care-coordination support through in-person contact and phone calls, problem-solving, motivational counseling, advocacy, education, resource navigation, and outreach.
Manage a caseload and coordinate services internally and externally, including updating client demographics, billing, and insurance information.
Monitor client screening tools, including PHQ-9, PHQ-9A, GAD-7, CSSRS, Social Determinants of Health, Gain-SS, Audit-C, Fagerstrom nicotine and tobacco-related tools, and Biosocial Gambling screening.
Monitor and assist clients with intake and six-month follow-up screening tools to track health and treatment progress.
Communicate effectively with staff, clients, providers, and family members during care coordination.
Educate clients about behavioral health conditions and attend and coordinate care-team meetings, assisting with treatment planning.
Contribute to quality of care and to discharge or transfer planning for clients discontinuing ElevaCare services or recently admitted to or discharged from hospitals or inpatient mental-health or substance-use treatment facilities.
Collect, maintain, and use available data to meet identified goals and determine appropriate client-centered motivational techniques and strategies.
Maintain appropriate boundaries and positive examples, ensure clinical records meet ElevaCare standards, and maintain confidentiality under ElevaCare, state, and federal guidelines.
Communicate appropriately with the supervisor regarding the assigned caseload and attend weekly Care Coordinator and one-to-one supervisor meetings.
Attend conferences and workshops at Center expense as directed and maintain contact with outside stakeholders as needed to gather feedback about program services.
Monitor hospital and emergency-room admissions and discharges through PointClickCare and ensure follow-up within 24 hours of discharge for ElevaCare clients and referrals.
Be available to provide support and assistance in emergency situations.
Provide services consistent with ElevaCare's mission and values and sensitive to clients' age, gender, language, sexual orientation, ethnicity, and cultural backgrounds.
Work effectively with team members, coordinate workflow, comply with applicable safety principles, laws, regulations, and standards, and respond to management needs such as data collection and program evaluation.
Travel as required, be available for evening and weekend work as required by Center needs, and perform other duties as assigned.