About this role
Care Navigator
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.
Key Details: Applicants for this role have the flexibility to work remotely from their home anywhere within the state of Missouri. This role provides education and support to pregnant members. A Missouri LPN license is strongly preferred. The work schedule is Monday - Friday, 8am - 5pm.
- 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 ex