Transforming the health of the communities we serve, one person at a time.
Care Navigator
Location
New Hampshire
Posted
9 days ago
Salary
$22 - $38 / hour
Seniority
Mid Level
Job Description
Care Navigator
Centene Corporation
• Develops, assesses, and coordinates care management activities based on member needs • Develops or contributes to the development of a personalized care plan/service plan for members • Educates members and their families/caregivers on services and benefit options • Evaluates the needs of the member, barriers to care, resources available • Recommends and facilitates the plan for the best outcome • Provides psychosocial and resource support to members/caregivers • Coordinates as appropriate between the member and care provider team • May monitor progress towards care plans/service plans goals • May perform on-site visits to assess member’s needs • Collects, documents, and maintains all member information • Complies with all policies and standards
Job Requirements
- Requires a Bachelor’s degree
- 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
- Current state’s clinical license preferred
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
Related Guides
Related Job Pages
More Care Navigator Jobs
• Primarily work in a virtual setting to support individuals with mental health conditions and substance use disorders, diagnosed and undiagnosed, and unmet needs with respect to social services • Perform initial and ongoing virtual outreach using an omnichannel approach to a qualified population with the goal of engaging identified individuals to understand the needs and barriers to care • Utilize motivational interviewing techniques to understand the individual’s care goals • Screen for unmet behavioral health, social service and physical health conditions and needs • Identify clinical needs and triage escalations, providing brief interventions, as necessary • Identify and address barriers to definitive behavioral health care • Identify the appropriate level of evidence-based care for the individual, as applicable • Support navigation of that individual to appropriate care, including behavioral health and/or primary care, as applicable • Support post-care follow-up
• Act as the primary point of contact for all patient related elements of the PSP. • Responsible for the timely enrollment of the patient into the Patient Support Program. • Telephone support (including maintenance calls and adherence support both inbound and outbound as needed). • Collaborate with the patient, insurer, and physician regarding the documentation necessary for maximal reimbursement coverage, including the investigation of all public and private insurers and supporting employer escalations as required. • Reviews the patient status and assists the prescribing physician to prepare documentation for public or private coverage by reviewing patient charts, assessing previous therapies and tests. • Provides therapy guidelines/education on the program to manage patient and physician expectations. • Collects information and conducts patient financial assessment eligibility based on program guidelines. • Liaise with physicians’ offices, pharmacies, infusion/injection services providers and other parties to provide comprehensive and coordinated service to patients and physicians and resolve issues as they arise. • Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy. • Review, analyze and validate information provided by patients for accuracy and completeness to ensure initiation and continuation of services. • Maintain service levels in case management, including telephone answer rates, time to initiate contact with the patient, Adverse Events reported as per SOPs, and any other KPIs established as the Program level. • Maintains accurate and timely patient/clinic information within the Customer Relationship Management (CRM) system. • Fosters and promotes a spirit of teamwork while working with internal patient support teams. • Identifies obstacles to obtaining coverage and channels this information to the PSP Supervisor. • Follow‐up/advocate until a decision is received, ideally securing coverage for the patient. • Maintains confidentiality of patient, client and corporate information and discusses same only with appropriate personnel. • Additional duties as requested by the Manager.
Clinical Care Navigator – After Hours
Spring HealthPrecise. Personal. Proven. The most comprehensive mental health care for teams and families everywhere.
• Provide in-the-moment clinical support, psycho education, and connection to appropriate referrals and resources on a clinical phone queue. • Utilize skills such as active listening, motivational interviewing, and solution-focused approaches to collaboratively engage with members seeking help with mental health, substance use, or family/relationship concerns. • Assess for risks and provide crisis support, safety planning, and follow up with high risk members to ensure safety and timely connection to care. • Recommend a plan of action based on clinical presentation and coordinate connection to appropriate care and services (Spring Health therapists, coaches, physicians, or external resources). • Provide after hours support to members and leaders seeking services or connection to the Global team, Management Consultation team, and Spring Internal team. • Use effective written skills to complete professional documentation and to interact with members and providers through email. • Follow care management outreach protocols and utilize good clinical judgment to identify and problem-solve barriers or disruptions to care. • Promote effective care by coordinating closely with Spring Health care providers and the Provider Operations team. • Interact and problem-solve with multi-disciplinary teams such as Care Support, Benefits/Billing, and Product to ensure a smooth member experience. • Participate in staff meetings, case consultations, and trainings. • Assist with onboarding and mentoring new team members. • Follow Spring Health policies and maintain all confidentiality, compliance, and ethical standards.
Clinical Care Navigator, Overnight
Spring HealthPrecise. Personal. Proven. The most comprehensive mental health care for teams and families everywhere.
• Provide in-the-moment clinical support, psycho education, and connection to appropriate referrals and resources on a clinical phone queue. • Utilize skills such as active listening, motivational interviewing, and solution-focused approaches to collaboratively engage with members seeking help with mental health, substance use, or family/relationship concerns. • Assess for risks and provide crisis support, safety planning, and follow up with high risk members to ensure safety and timely connection to care. • Recommend a plan of action based on clinical presentation and coordinate connection to appropriate care and services (Spring Health therapists, coaches, physicians, or external resources). • Provide after hours support to members and leaders seeking services or connection to the Global team, Management Consultation team, and Spring Internal team. • Use effective written skills to complete professional documentation and to interact with members and providers through email. • Follow care management outreach protocols and utilize good clinical judgment to identify and problem-solve barriers or disruptions to care. • Promote effective care by coordinating closely with Spring Health care providers and the Provider Operations team. • Interact and problem-solve with multi-disciplinary teams such as Care Support, Benefits/Billing, and Product to ensure a smooth member experience. • Participate in staff meetings, case consultations, and trainings. • Assist with onboarding and mentoring new team members. • Follow Spring Health policies and maintain all confidentiality, compliance, and ethical standards.



