Care Navigator

Care Navigator

Requirements

• 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.
• Current state’s clinical license preferred.
• For Mississippi Magnolia Health plan: Bachelor’s or Master’s degree in a healthcare related field (social work, sociology, psychology, public health) and 2 – 4 years of related experience; LSW,LMSW preferred.

Responsibilities

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

Preferred Qualifications

• Preferred experience in Obstetrics /Maternal Health.