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Transforming the health of the communities we serve, one person at a time.
Care Navigator | King County
Location
United States
Posted
107 days ago
Salary
0
No structured requirement data.
Job Description
Care Navigator | King County
Centene Corporation
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Local community role: Must live in Central/North King County, WA - (Seattle, Tukwila, SeaTac, Burien, Renton) Consistent schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. - (with some flexibility) Get out in the community: 50%–75% travel within King County - Coordinate care for high-risk members and support their ongoing health goals - Visit members in homes and community settings (hospitals, shelters, provider offices, etc.) - Conduct proactive phone outreach to build trust and keep members on track Position Purpose: 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 health care access and receive appropriate high-quality care through advocacy and care coordination. - 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 a personalized care plan/service ongoing 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 manager 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. Education/Experience: Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is 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. License/Certification:Current state’s clinical license preferre Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. 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 may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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Overview Who We Are: National Louis is a 135+ year old university that has been grounded in the values of innovation, access, excellence, and equity from its inception. As an institution, we believe in providing access to educational opportunity and that education is our greatest lever for social and economic mobility. We are a student-focused community that is committed to continuous improvement and superior student service. We believe that through education we are able to empower change and build healthy communities. Our hard-working community is based on collaboration and respect for all team members and students. What You Will Do: Responsible for providing assessment for Chicago Public Schools early childhood programs, conduct inter-reliability assessments, and write accurate reports Essential Responsibilities - Provides evaluation of City of Chicago early childhood programs. - Prepares and submits evaluation reports according to the required time frame and criteria. - Participates in inter-rater reliability training for all required evaluation tools and maintains required level of reliability. - Attends all assessment team, supervision, and all-staff meetings. Qualifications - Bachelor's Degree in Early Childhood Education or related field, Master's degree strongly preferred. - Three to five (3-5) years teaching or administrative experience in the field of early childhood education. - 1+(plus) years high level of prior leadership experience and skill. - 1+ (plus) years high level of reliability on observation tools. - Willing to travel within Chicago, and to Wheeling as needed - Willing to attend ongoing training to obtain and retain on assessment tools - Prior experience in early childhood assessment preferred. Work Environment/Physical Demands/Travel Requirements This is a remote position within the City of Chicago. This position requires city-wide travel, word processing and computer skills, walking, bending, classroom environment-continuous standing, lifting boxes, setting up training environments. This position will be required to come into the Chicago, Wheeling, or Lisle campus for special meetings/events. NLU Inclusion Statement: National Louis University is deeply committed to serving its community, advancing access and equity, and ensuring that all individuals are welcomed and valued. We are dedicated to fostering a culture where diversity, equity, and inclusion remain at the core of who we are. These are more than just words to us: they are truly a way of life for the NLU community. We recognize that differences in abilities, age, ethnicity, gender (identity and expression), race, religion, sexual orientation, socio-economic status, and background bring richness to our work environment. We affirm diverse perspectives, innovative contributions, and authentic presentations of self from every member within the NLU community. We believe inclusion is grounded in the actions we intentionally take each day. Our goal is to inspire and empower NLU employees and community members to cultivate an environment where we collectively focus on uplifting and advancing our institutional culture. Compensation and Benefits At National Louis University, we offer our employees an innovative environment to work together and inspire the ideas that will make an impact. As our external environment changes, our employees are provided the opportunities and tools needed to grow both personally and professionally to remain successful. NLU employees and dependents are offered a wide range of benefits, including but not limited to, Health Insurance benefits, Retirement benefits, Paid Time Off and Educational Opportunities. Additional information regarding full-time staff benefits can be found here. The salary range of the grade for this position is $51,966 to $75,351 annually. Compensation decisions are dependent upon the facts and circumstances of each position and candidate. Offers are based on multiple factors permitted by law, including but not limited to: budgetary considerations, job-related knowledge/skills, experience, market considerations, tenure and standing with the university (applicable to current employees), and internal equity. Application Instructions Please Include the following along with your application: - Resume (Required) - Cover Letter (Optional) - Current NLU employees please also submit an Internal Posting Form
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This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves collecting receivables and monitoring past due accounts. It also includes researching and resolving insurance claim discrepancies. - Reviews patient account files received for discharged patients and ensures the accuracy and completeness of all documents. - Identifies portion of charges to be billed to patients’ insurance companies, Medicare or other third parties, and those to be billed to the patient directly. - Prepares appropriate billing statements for insurance companies, Medicare or other third parties. - Replies to patients’ and insurance company requests for information. - Assists in the preparation of billing activity reports. - Prepares and maintains billing files and reports. - Investigates delinquency cases to identify any special circumstances affecting payment delays and follows up with appropriate parties. - Contacts third party payer organizations and/or patients as necessary to facilitate the timely payment of past due charges or arranges alternative settlement plans. - Identifies problem delinquencies and recommends their appropriate disposition (i.e., referral to collection agency or other legal action, or write-off). - Prepares and maintains records and reports documenting the status and amount of past due accounts, and the timing and nature of their disposition. Qualifications - High School Diploma or equivalent. Requirements - 2 years hospital medical billing experience preferred. - Excellent oral and written communication and interpersonal skills. - Computer literate. - Knowledge of Medicare, State Programs, and commercial billing. - Must read, write and speak fluent English. - Must have good and regular attendance. - Performs other related duties as assigned.

