Non-Licensed Care Navigator

Summary / Objective:
Working in conjunction with a Care Management nurse, the Non-Licensed Care Navigator (CN) is responsible for providing outreach and education services for identified high-risk members. This position requires strong interpersonal skills to make connections and build relationships with vulnerable populations. The CN works collaboratively with nursing staff, the Primary Care Provider and other community based agencies with the purpose of making the critical linkages to health information and services. Additionally, this position is often the first point of contact and is responsible for managing inquiries for the Care Management Department. The CN will work to establish relationship and connection with the client’s familial and friend support network and serve as a non-adversarial bridge to promote and foster collaboration and communication between all involved parties. The CN will assist with outreach and record encounters in accordance with PSW documentation standards. Navigators provide clerical and administrative support to for Care Management Nurses, support beneficiaries in reaching their personal and medical care plan goals, and assist with care coordination.

Essential Functions:
·   Deploy home monitoring devices to eligible members.
·   Conduct outreach, engagement and education activities to identified beneficiaries.
·   Provides liaison services between clients, potential clients, family members and other social agencies.
·   Assists in scheduling appointments for clients to meet with program professionals.
·   Identify health barrier information as well as patient identified goals.
·   Promote the skills needed by clients and families needed to effectively navigate the health care system. Advocate for clients unable advocate for themselves.
·   Assists clients and their families in completing forms and applications to receive services, including but not limited to Medicaid applications.
·   Assists clients and their families in achieving identified health improvement and stabilization goals.
·   Builds collaborative relationships within and outside of PSW.
·   Develop high level of expertise on existing resources and support services available to seniors.
·   Participate as a successful member of multi-disciplinary team, understanding the value of individual work styles, roles and standards.
·   Assures that all documents and reports are compliant with regulatory requirements and meet PSW, HIPPA and health plan standards for content and timeliness.
·   Provide CMS and health plan audit support by identifying, reviewing, editing and submitting appropriate requested data and participating in audits as required.
·   Participate in required trainings and attend Department team meetings. Continue own education by staying informed of industry trends and common issues faced by health compromised services.

Knowledge/Skills/Abilities:
·  Maintain a pleasant, professional and approachable demeanor at all times.
·  Flexible and willing to work in a dynamic and evolving role according to individual patient and program demands.
·  Proactive team player, strong follow through, quick decision making abilities and ability to problem solve.
·  Interpersonal skills, with the ability to build strong relationships at all levels.
·  Meet clients “where they are at” without judgment and criticism.
·  Aware of own personal values and biases and able to work with clients with different values and belief systems.
·  Experience, comfort and skill in working with crisis and conflict resolution.
·  Experience working with culturally diverse communities and families
·  Strong verbal and written communication skills with customers, supervisors and co-workers.
·  Strong organizational, time management and prioritization skills.
·  Basic knowledge of appropriate boundaries and limits around personal self-disclosure when working as a provider of health and support services.
·  Self-starter. Ability to set priorities and keep to projected schedules.
·  Excellent computer proficiency (MS Office – Word, Excel and Outlook) including being able to effectively maintain written and computer records in accordance with  regulatory agencies.
·  Is aware of and supports strategic plans that ensure department and/or company objectives and goals are obtained.
·  Implement new policies, procedures and company initiatives as assigned and ensures all areas are maintained in accordance with company policy, state, federal and plan regulatory mandates.