• Job Description

  Req#: R9451

  Job Summary:

  The Navigator is responsible for coordinating logistics for plan adherence – reminders, transportation, and childcare arrangements - for our members and accompanying patients to appointments and other social service encounters when necessary.

  Essential Functions:

  • Ensure that medication adherence issues for our members are addressed by ongoing reporting of issues to the CareSource Case Manager
  • Supporting patient family members
  • Verify eligibility, previous enrollment history, demographics and current health status of each member
  • Contribute to assessments by gathering information from the member, family, provider and other stakeholders
  • Contribute to the development and implementation of care plan, defining specific issues, goals and interventions as agreed to by all parties
  • Assist with evaluation of care plan on an ongoing basis through member, family, provider and stakeholder contact
  • Facilitate and coordinate services based upon the care treatment plan developed in collaboration with all stakeholders
  • Contributes to team coordination and member outcomes
  • Assist in education of member/caregivers regarding healthcare access and benefits, and provide member/caregiver with health education and wellness materials
  • Participate in the implementation of comprehensive care plans by working with CareSource members in various community, care delivery and administrative settings, developing relationships with community providers and resources, and managing resources through interdisciplinary collaboration to achieve optimal patient outcomes
  • Maintain current and accurate documentation within the care management electronic record
  • Maintain appropriate documentation within protocols and guidelines of the Care Management program
  • Provide timely and accurate documentation
  • Actively participating in team meetings
  • Develop and maintain knowledge of the company’s business and regulatory environments
  • Regular travel to conduct member visits, provider visits and community based visits as needed to ensure effective administration of the program
  • Perform any other job duties as requested

  Education and Experience:

  • High School Diploma or General Education Diploma (GED), is required
  • Two years of experience in either volunteer or paid position working in community settings with at risk populations providing coordination of services, is preferred

  Competencies, Knowledge and Skills:

  • Sensitivity to and experience working within different cultures
  • Comfortable and interested in working with members around issues of healthcare access and adherence
  • Appropriate language proficiency
  • Ability to separate personal from professional and to set boundaries with members
  • Excellent understanding of local and community resources
  • Excellent interpersonal skills
  • Ability to work within a team environment
  • Ability to perform navigation with minimal supervision
  • Ability to identify problems and opportunities for Patient Navigation and report to CareSource Care Coordination Center’s Team
  • Ability to work in compassionate, supportive and collaborative ways with members and families
  • Self-motivated and Inquisitive
  • Comfort with asking pertinent questions
  • Ability to work in a fast-paced environment
  • Ability to demonstrate and promote ethical conduct
  • Ability to develop positive relationships with all stakeholders
  • Empathy and sensitivity towards each member
  • Ability to accept and appreciate feedback
  • Ability to provide input in assessing the needs of members and participate in the development of comprehensive care plans
  • Knowledge of healthcare resources, benefits and entitlements in the local area
  • Organized , detail-oriented and conflict resolution skills
  • Initiative to plan and organize projects
  • Ability to keep composure and professionalism during times of high emotional stress
  • Ability to maintain confidentiality and act in the company’s best interest
  • Ability to act with diplomacy and sensitivity to cultural diversity

  Licensure and Certification:

  • Harold P. Freeman Patient Navigation Institute Certification, or equivalent approved training program, is preferred
  • Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated
  • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
  • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

  Working Conditions:

  • General office environment; sitting or standing for long periods of time may be required
  • Will work at local office locations established by CareSource and will typically work in established geographical area in the community; will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time
  • Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
  • Reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
  • May be required to travel greater than 50% of time to perform work duties. A valid driver’s license, car, and insurance are necessary for work related travel
  • Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
  • Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our member and may refer members to other CareSource resources

  Compensation Range:

  $35,200.00 - $56,200.00

  CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

  Compensation Type (hourly/salary):

  Hourly

  Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

  
  

  This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

  #LI-JM1

• About the company

  CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio.

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