INTAKE NAVIGATOR

About the role

The Intake Navigator will directly educate a prospective participant through the onboarding process leading to enrollment in CenterLight’s Program of All-inclusive Care for the Elderly (PACE). This person will work closely with referral sources, account managers, clinical intake and provider relations to ensure all and tasks are efficiently completed associated with the enrollment process. The Intake Navigator is expected to maintain ethical conduct, compliance with state, federal and PACE regulatory requirements, and will be responsible for quality and satisfaction of prospective participants, caregivers and referral sources.

Responsibilities

• Correspond directly with the prospective participants to provide plan education and qualification screening.
• Respond to all incoming/outgoing calls, data entry, emails.
• Schedule assessments and mail information to prospective participant.
• Meet the departmental productivity goals as specified by management for the growth of the company.
• Become an expert about CenterLight PACE program eligibility requirements, services and benefits.
• Address eligibility issues, application processing and referrals to Maximus to resolve potential participant issues.
• Work closely with all departments to onboard and retain participants.
• Obtain referral details to assess and determine appropriate next steps for expeditious enrollment processing.
• Evaluate factors unique to each referral including, but not limited to their clinical condition, financial situation, their entitlements status and home support systems.
• Use knowledge obtained through the qualification screening to determine which government agencies and team members (entitlements specialists, assessment nurses, etc.) should be assigned to the prospect or caregiver in the next step of enrollment.
• Verify plan and entitlement status utilizing LDSS/HRA/CMS resources and functions.
• Perform provider network verification and other validation of provider participation.
• Enter calls/inquiries into central database for tracking and follow-up and schedule appointments with the prospect/caregiver.
• Monitor and report Intake team performance measures to improve delivery and execution of onboarding procedures (CDPAS enrollment, acquisition of entit