Care Navigator

Position is remote. Must live in Mississippi.

About the role

Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve healthcare access and receive appropriate high-quality care through advocacy and care coordination.

Responsibilities

• Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome.
• Develops or contributes to the development of personalized care plans/service plans and works to identify providers, specialists, and/or community resources needed for care.
• Provides psychosocial and resource support to members/caregivers and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care based on service assessment and plans.
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner.
• May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs; refer to care management for further evaluation as appropriate.
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• May perform on-site visits to assess member’s needs and collaborate with providers or resources, as appropriate.
• May provide education to care managers and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits.
• Other duties or responsibilities as assigned by people leader to meet the member and/or business needs.
• Performs other duties as assigned.
• Complies with all policies and standards.

Requirements

• Bachelor’s degree and 2 – 4 years of related experience.
• Graduate from an Accredited School of Nursing if holding clinical licensure.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope, and skill reflective of the level of this position.
• Will work with Foster Care population.

Qualifications

For Mississippi Magnolia Health plan:

• Bachelor’s or Master’s degree in a healthcare related field (social work, sociology, psychology, public health) and 2 – 4 years of related experience.
• LSW, LMSW preferred.

Pay

$22.94 - $38.79 per hour. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules

Benefits may be subject to program eligibility.