Care Navigator

Location: Poughkeepsie, NY
Hours: Mon-FRi 930 am to 6 pm
Rate of Pay: 24.04

Job Description:

The position of Care Navigator (CN) is responsible for working closely with individuals to promote effective connection and collaboration to services. Care Navigators are committed to assisting in removing the barriers to care by identifying critical resources, navigating through health care services, insurance plans, and systems. Care Navigators help individuals "navigate" the maze of insurances, administrative systems and support services. They focus on integrating services around the needs of the individual.

Effective Care Navigators build working relationships, solve problems, direct to resources, and manage information.

The Care Navigator responsibilities include coordination to improve quality of care through the efficient use of resources and thereby enhancing quality, cost-effective outcomes.

• Act as an advocate and assist in coordination of care to minimize the fragmentation of health care delivery systems.
• Gather insurance information.
• Assist in navigating the complex healthcare and insurance systems.
• Assist in securing health insurance.
• Assist with completion of paperwork for the sliding scale fee.
• Complete referrals to care management services and other internal and external services as needed.
• For referrals to care management (internal) – follow up with the individual until a warm hand-off to care management is complete.
• Identify and effectively utilize community resources to meet the needs of the member/family. Facilitate access to community resources.
• Collaborate with providers and other healthcare team members, to include the member’s payer, in order to facilitate care across the healthcare continuum and optimize clinical and financial outcomes.
• Maintain a working knowledge of payer requirements. Negotiate on behalf of the member for cost-effective, high quality services and to maximize the efficient use of resources.
• Serve as a liaison to providers, members and families for coordination of services.
• Document all interventions using the Complex Care Management billable documentation.
• Work collaboratively as part of a team.

KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent written, verbal and listening abilities. Communicate appropriately and clearly to staff and providers.
• Willingness to establish effective working relationships with internal and external providers / resources. Maintain a good working relationship within the department and with other departments.
• Ability to manage conflict, stress and multiple simultaneous work demands in an effective and professional manner.
• Ability to work well independently, while collaborating with other team members.
• Ability and willingness to self-motivate, to prioritize and change processes to improve effectiveness and efficiency. Adapts to changing program or organizational priorities.
• Ability to make independent decisions in accordance with established policies and procedures. Decisions and problem solving require a combination of analysis, evaluation and interpretive thinking.
• Knowledge of and appreciation for cultural diversity and low literacy issues in care provision.
• Computer literacy. Ability to navigate Electronic Health Records and other systems.

Education

• Bachelor's Degree in Health and Human Services or related field (major concentration in social work, psychology, nursing, rehabilitation, education, occupational therapy, physical therapy, recreation or recreation therapy, counseling, community mental health, child and family studies, sociology, speech and hearing or other human services field) or
• NYS licensure and registration as a Registered Nurse and a bachelor's degree or
• Bachelor's level education or higher in any field with five years of experience working directly with highly vulnerable populations (i.e. those with health, behavioral health, substance use issues), or a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) or
• 5 years experience
• Bilingual English and Spanish speaking preferred

Experience

• Two years of experience
• In linking individuals with SMI, Developmental Disabilities, or alcoholism or substance abuse to a broad range of services essential to successful living in a community setting
• A Master’s degree in a related education field may be substituted for one year of experience.

EOE M/F/D/V