Care Navigator

Position Title: Care Navigator

Work Location: Member-facing- source from South Carolina, PD Region, Grand Strand Region

Assignment Duration: 3 months (with potential to extend/convert)

Work Schedule: Monday - Friday, 8 am-5 pm / 9 am-6 pm

Work Arrangement: Remote, field visits required

Position Summary:

Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes.

Key Responsibilities:

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  Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome

  
  
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  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

  
  
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  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

  
  
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  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

  
  
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  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

  
  
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  Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

  
  
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  May perform on-site visits to assess member's needs and collaborate with providers or resources, as appropriate

  
  
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  May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits

  
  
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  Other duties or responsibilities as assigned by people leader to meet the member and/or business needs

  
  
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  Performs other duties as assigned.

  
  
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  Complies with all policies and standards.

  
  

Qualification & Experience:

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  Requires a Bachelor's degree and 2 - 4 years of related experience. Graduate from an Accredited School of Nursing if holding clinical licensure.

  
  
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  Equivalent experience may be considered.

  
  
• Certified Community Health Worker required.
• ?Licensure preferred: Current state clinical license.