What are the responsibilities and job description for the Health Care Navigator Case Certified Nursing Assistant position at National Benefits Administrators, LLC.?
Job Description
Health Care Navigator Certified Nursing Assistant
POSITION SUMMARY/MISSION:
Under the supervision of a registered or licensed practical nurse, provides support to clients with high-risk members on navigating access to quality and cost-effective health care services and benefit coverage to prevent increased medical costs. Support will be provided within the member’s home, hospital, or provider’s office to promote effective utilization of available resources, optimize member functioning, and ensure cost-effective outcomes.
PILLARS OF THE PROGRAM:
Ensure patient, employer, & consultant privacy using the HIPAA privacy rule federal, state and consultant company compliance
Support & encourage patient – provider relationship
Maintain trust and respect
Recognize the importance of Social Determinants of Health: Income, Education, Employment, Housing, Environment, Social Support, and Access to Healthcare and how this impacts the patient’s health outcomes.
DO NO HARM
Enhancement of Medical Appropriateness and Quality of Care:
Use a holistic approach by consulting with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers in meeting the patient's goals and objectives.
Identify and improve quality of care issues through appropriate, established channels.
Ability to speak to a multi-disciplinary healthcare network consisting of medical, behavioral, and other allied health professionals to influence the patient’s overall care.
Utilize influencing/motivational interviewing skills to ensure maximum member engagement, which in turn helps promotes lifestyle/behavior changes to achieve optimum level of health.
Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Assist members actively and knowledgably participate with their provider in healthcare decision-making.
Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
Monitoring and Evaluation and Documentation of Care:
Initiate contact with the member preferably face to face as much as possible but if not applicable member preference
In collaboration with the member and their care team, follow established plans of care to meet the member’s goals and provide feedback to nurse supervisor as appropriate.
Adhere to care management and quality management processes in compliance with regulatory and company policies and procedures.
Attend weekly clinical team meetings and other meetings, as required.
Education And Experience
Education and Experiential Requirements:
Current Hawaii CNA license (in good standing). Require: Tagalog. Preferred: a minimum of 3 years of clinical experience in medical-surgical, community/home health care, case-management, and/or equivalent experience reviewing patient medical care and services or similar.
Preferred a CNA with a professional interest to further pursue a career in nursing.
Effective writing skills, interpersonal communication skills, well-organized, the ability to multitask and work independently to promote flexibility and teamwork.
Excellent customer service skills to both internal and external customers.
Able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.
Able to maintain confidentiality of patient information according to Federal (HIPAA), organizational, and departmental policies.
Effective, working knowledge of Microsoft Office suite.
Experience with electronic medical records.
Health Care Navigator Certified Nursing Assistant
POSITION SUMMARY/MISSION:
Under the supervision of a registered or licensed practical nurse, provides support to clients with high-risk members on navigating access to quality and cost-effective health care services and benefit coverage to prevent increased medical costs. Support will be provided within the member’s home, hospital, or provider’s office to promote effective utilization of available resources, optimize member functioning, and ensure cost-effective outcomes.
PILLARS OF THE PROGRAM:
Ensure patient, employer, & consultant privacy using the HIPAA privacy rule federal, state and consultant company compliance
Support & encourage patient – provider relationship
Maintain trust and respect
Recognize the importance of Social Determinants of Health: Income, Education, Employment, Housing, Environment, Social Support, and Access to Healthcare and how this impacts the patient’s health outcomes.
DO NO HARM
Enhancement of Medical Appropriateness and Quality of Care:
Use a holistic approach by consulting with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers in meeting the patient's goals and objectives.
Identify and improve quality of care issues through appropriate, established channels.
Ability to speak to a multi-disciplinary healthcare network consisting of medical, behavioral, and other allied health professionals to influence the patient’s overall care.
Utilize influencing/motivational interviewing skills to ensure maximum member engagement, which in turn helps promotes lifestyle/behavior changes to achieve optimum level of health.
Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Assist members actively and knowledgably participate with their provider in healthcare decision-making.
Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
Monitoring and Evaluation and Documentation of Care:
Initiate contact with the member preferably face to face as much as possible but if not applicable member preference
In collaboration with the member and their care team, follow established plans of care to meet the member’s goals and provide feedback to nurse supervisor as appropriate.
Adhere to care management and quality management processes in compliance with regulatory and company policies and procedures.
Attend weekly clinical team meetings and other meetings, as required.
Education And Experience
Education and Experiential Requirements:
Current Hawaii CNA license (in good standing). Require: Tagalog. Preferred: a minimum of 3 years of clinical experience in medical-surgical, community/home health care, case-management, and/or equivalent experience reviewing patient medical care and services or similar.
Preferred a CNA with a professional interest to further pursue a career in nursing.
Effective writing skills, interpersonal communication skills, well-organized, the ability to multitask and work independently to promote flexibility and teamwork.
Excellent customer service skills to both internal and external customers.
Able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.
Able to maintain confidentiality of patient information according to Federal (HIPAA), organizational, and departmental policies.
Effective, working knowledge of Microsoft Office suite.
Experience with electronic medical records.