Care Navigator

Summary

Work in conjunction with the Care Manager to deliver integrated, whole-person care management addressing a member's physical health, behavioral health, intellectual/developmental disability (I/DD), traumatic brain injury (TBI), long-term services and supports (LTSS), and/or pharmacy needs, in addition to unmet health-related resource needs. Provide services in accordance with care management service requirements set by the state and company.

Responsibilities

• Supports Care Managers in delivering care management.
• Engages the member/family/guardian with professionalism, compassion, and purpose through telephonic and virtual methods and in-home visits as required. Interactions should be concise, respectful, in a language of his/her choice, and non-judgmental.
• Establishes a professional rapport with all team members, stakeholders, peers and supervisors.
• Initiates the first contact with the member/family/guardian to complete the preliminary questionnaire.
• Communicates with the Case Manager any information pertaining to the care and well-being of the member/family/guardian.
• Provides documentation of billable events that align with minimum contact expectations to the Care Manager.
• Maintains an accurate, up-to-date electronic information data stream on all interactions, encounters, activities, and communications with the member/family/guardian.
• Performs general outreach, engagement, and follow up with members, to encourage accomplishment of goals set in the Plan/ISP.
• Coordinates services/appointments.
• Engages in health promotion activities and knowledge sharing.
• Shares information with the Care Manager and other members of the care team on the member's circumstances.
• Provides and tracks referrals and provides information and assistance in obtaining and maintaining community-based resources and social support services.
• Participates in case conferences and planning meetings.
• Supports the Care Manager in identifying and addressing barriers to services, gaps in service, and unmet health-related needs proactively, expanding relationships and linkages to aid in meeting member's needs.
• Provides services that meet national, state, and local healthcare standards at the highest level.
• Reports issues of concern, general departmental activities and staffing needs to the Care Manager.
• Completes all required training and participates in educational sessions to improve overall skills.
• Attends industry meetings, training, and functions to promote positive relationships with stakeholders.
• Participates in quality improvement and measurement activities to achieve identified targets and outcomes.
• Performs other related duties and activities as required.

Requirements