Health Navigator (NR12-013)
Location: Farmington Connecticut
Description: ConnectiCare Inc. is presently looking of Health Navigator (NR12-013) right now, this occupation will be placed in Connecticut. Further informations about this occupation opportunity kindly read the description below. Reports to: Supervisor, Medicare Case Mgmt UnitFLSA: ExemptManages: NonePurpose: Provides telephonic health navigation services to high-risk dual eligible members enrolled in ConnectiCare's Medicare Advantage products. Navigator services include Care Transition Interventions, appointment scheduling, transportation coordination, telephonic outreach, dissemination of educational messages, and linkage to internal and external/community resources. Works directly with members, caregivers and other health care delivery system entities, and communicates with physicians and nursing staff to enhance the coordination of care for members.KEY ACCOUNTABILITIES:1. Independently completes designated call outreach to Medicare beneficiaries for the purpose of program introduction, health screening, psychosocial assessment, functional assessment, health coaching and/or triage.2. Expected to manage a flexible work schedule in order to meet the needs of beneficiary and to optimize reach rates.3. Utilizes good judgment and discretion in referring cases to a Nurse Case Manager, Social Work Case Manager and/or Pharmacist when appropriate.4. Enters and maintains critical data in ConnectiCare case management/ physician office electronic medical record systems meeting defined timeframes and performance standards.5. Provides Care Transition Interventions including discharge plan review, medication review, ensures post-discharge appointment with PCP or specialist, assists with scheduling needed tests, arranges for transportation identifies early warning signs for re-hospitalization and creates a plan of action with member, and links member to internal and external resources6. Identifies all HEDIS measures for which the member is eligible, determines if member is already compliant and if works with the member to achieve HEDIS compliance for all eligible measures7. Identifies chronic conditions that have not been diagnosed and documented in the calendar year and works with PCP to ensure member has a PCP visit and the conditions are appropriately captured. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.8. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.9. Performs other related projects and duties as assigned. 1. At least 3 - 5 years experience in a managed care setting with familiarity with care coordination is required. Experience in discharge planning, care transition interventions, HEDIS measures and HCC coding preferred is desirable.2. Excellent oral and written communication, organizational, and interpersonal skills required.3. Previous system user experience in a highly automated environment and strong personal computer literacy on Windows products required.4. Demonstrated ability to work independently and effectively offsite, and to prioritize multiple tasks required.5. Experience with coordination of internal and external/community resources preferred6. Bilingual in English/Spanish or English/Polish preferredCOMPETENCIES:1. Member and Customer Focus: Recognizes that members and customers (internal & external) are the driving force behind every business activity. Continuously makes an effort to exceed the expectations of members and customers.2. Quality Orientation: Assumes responsibility for providing the highest level of quality to members and customers.3. Innovation: The ability to see opportunities for change, to capitalize on them and implement them when appropriate for the benefit of ConnectiCare.4. Communication: The ability to communicate with clarity both orally and in writing.5. Teamwork: Demonstrates enthusiasm for the mission of ConnectiCare and inspires the same in others.6. Results Orientation: The ability to break a complex problem down into its component parts and arrive at the appropriate solution in a timely fashion.7. Change Mastery: Embraces change.8. Learning Orientation: Assumes responsibility for personal and professional development.ConnectiCare is an equal opportunity employer. M/F/D/V
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This occupation starts available on: Fri, 31 Aug 2012 12:09:01 GMT