Care Coordination Navigator

About the position

The Care Coordination Navigator is responsible for guiding and supporting members in making sustainable lifestyle changes to improve their overall health and well-being. This position, in collaboration with the Care Management Registered Nurses, works closely with members to create personalized wellness plans, reinforce education, and offer ongoing support to help them reach their health goals.

Responsibilities

• Collaborates closely with team members to facilitate members' access to essential services.
• Engages with patients and their caregivers to enhance involvement and address obstacles throughout their healthcare journey.
• Empowers members to adopt positive changes in diet, exercise, stress management, and safety practices.
• Reviews and manages care referrals for registered participants and non-registered participants.
• Assesses members' needs during telephonic and/or digital interactions and refers them, as necessary, for targeted medical support.
• Applies motivational interviewing techniques in tandem with members' readiness to reinforce mutually agreeable goals for progress.
• Reaches out proactively to eligible members, encouraging enrollment in the program.
• Distributes approved health education materials to program participants through online resources, mail, or digital applications.
• Reinforces engagement strategies to encourage member participation in preventive care, health screenings, and wellness programs offered by the insurance company or its partners.
• Connects patients and their families to community-based resources and performs follow-up to ensure resources met needs based on social determinants of health identified needs.
• Enters referrals and documents communications, actions, and other data in appropriate system(s) to maintain records for audit purposes.
• Performs work under direct supervision.
• Handles basic issues and problems and refers more complex issues to higher-level staff.

Requirements

• An associates degree required in healthcare, business or related field.
• 2 years of experience in healthcare, insurance, customer service, or related experience in a direct patient care setting.
• Basic clinical knowledge with the ability to apply foundational clinical concepts in daily work.
• Ability to communicate effectively with members, caregivers, and team members using strong interpersonal skills.
• Demonstrated ability to make sound decisions and use good judgment within the scope of the role.
• Ability to adapt to changing priorities, workflows, and member needs with flexibility.
• Strong collaboration skills with the ability to work effectively within a team environment.
• Clear verbal and written communication skills to support member interactions and documentation.
• Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Nice-to-haves

• Experience as a Community Health Worker preferred.
• Experience working with populations that have social needs.

Benefits

• Affordable medical, dental and vision coverage accepted throughout the United States
• Employer funded Lifestyle Spending Accounts and Health Savings Accounts.
• Voluntary employee contributions to Health Savings Accounts and Flexible Spending Accounts
• Employer-paid life and disability insurance
• 401(k) retirement plan with company match and immediate vesting
• Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
• Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.
• Additional company perks
• Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
• Comprehensive learning and development opportunities and an Educational Assistance Program.
• 16 hours of paid volunteer time with a \$200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Opportunities to connect through employee committees.