What are the responsibilities and job description for the Navigator - Call Center position at Central Florida Health Care, Inc.?
Title: Patient Centered Medical Home Navigator - Call Center
Reports to: Call Center Manager
FLSA Status: Non-Exempt
Personnel Supervised: None
Personnel Supervised: None
POSITION SUMMARY:
The Patient Centered Medical Home Navigator is responsible for assisting clients in the application of various public assistance programs and social needs.
MINIMAL QUALIFICATIONS:
- Education: Associate degree with the major focus being a medical or Social work environment. (will accept HSD and equivalent experience)
- Experience: One year of experience where the major responsibility was in any one of the following categories - public health, community health center, economic services, counseling, investigating, medical billing/collections, and/or processing insurance claims.
- Bilingual: English/Spanish Preferred
SKILLS:
- Must be able to assist in the application of various public assistance programs, entering very sensitive information into a variety of computer systems in a fast-paced environment.
- Expected to handle a high volume of work with strict deadlines.
- Must be able to prioritize work and be flexible to changes at any moment.
- Must be able to work with clients who may be unable to read, write and are unable to operate a computer.
- Must abide by the policies, procedures, laws, rules and regulations of Central Florida Health Care, Inc., the Department of Children and Families, Florida Healthy Kids Corporation (Kid Care), Federal Exchange market place and any other social program for which an application is made.
- Must be prepared to report suspected child or elderly abuse as well as suspected fraud to the appropriate authorities.
- Must have knowledge of community resources.
- Must be computer literate.
- Must be culturally sensitive.
RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:
- Ensure all required Training of the Affordable Care Act for the certified application counselors is completed contractual deliverables are provided (patient education and notices)
- Provide service to a minimum of 12 documented customers per day.
- Conduct phone interviews for case management that will evaluate, assess and plan for client’s social welfare needs that may otherwise be a hindrance to optimum delivery of health care. This will be documented on the patient progress note which will have an assessment and associated current procedural terminology.
- Coordinate with individual hospitals to assure patient completed Medicaid application process, if applicable.
- Liaison with providers and/or agencies providing economic services and other required services in order to establish economic services eligibility.
- Travel to other CFHC sites, meetings, trainings, and other CFHC activities when required.
- Assist and verify the client’s application process for Medicaid eligibility or CHIP, FL KidCare.
- Assist with enrollment, understanding the difference between health plans, choosing a plan, and using that plan, if necessary.
- Monitor client application process and appointment compliance over time and assist client with complying with required, accurate documentation needed to assess Medicaid FL KidCare and/or Social Security eligibility, when appropriate. This includes completing all required paperwork with the client.
- Create and maintain database of client applications, monitoring approvals/denials on a monthly basis.
- Conduct on-going contact by phone .
- Act as an advocate for the client and/or care giver.
- Provide referrals to appropriate departments, agencies and community programs as necessary for case management under PCMH.
- Availability and choice of appointment times should attempt to accommodate the client’s schedule and needs.
- Attend all PCMH Navigator meetings, as appropriate.
- Work with All Central Florida Health Care, Inc. staff to ensure continuity of care is maintained and address needs that are barriers to care.
- Other duties as assigned.
BENEFITS:
Competitive Salary
Federal Student Loan Forgiveness:
PSLF – 10-year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven
Excellent medical, dental, vision, and pharmacy benefits
Employer Paid Long-Term Disability Insurance
Employer Paid Life Insurance equivalent to 1x your annual salary
Voluntary Short-Term Disability, additional Life and Dependent Life Insurance are available
Malpractice Insurance
Paid Time Off (PTO) – 4.4 weeks per year pro-rated
Holidays (9.5 paid holidays per year)
Paid Birthday Holiday
CME Reimbursement
401k Retirement Plan after 1 year of service (w/matching contributions)
Staff productivity is recognized and rewarded
PHYSICAL REQUIREMENTS:
1. Requires 80% or more time spent standing/sitting.
2. Independently mobile
3. Lifting and/or transporting up to 20 pounds.
2/18/2025
