Health Navigator -Community Supports

Job Details

Job Location
Main Office - Santa Barbara, CA

Position Type
Full Time

Education Level
Bachelor's Degree

Job Category
Medical Management

Description

California Hourly Rate Range: $32.35 - $46.91 per hour

Job Summary

The Health Navigator (HN) for the Community Supports (CS) Program (HNCS) will assist with the coordination of care issues, process and make determinations for CS referrals. The HNCS will assist members, providers, or other internal departments with complex community support issues in a timely manner. This position will support the CS Program Manager in reviewing and developing CS reports, workflows, or training material associated with Community Supports. This position will report directly to the CS Program Manager.

Duties and Responsibilities

In conjunction with CS Program Manager, will assess community/membership needs to expand CS Services.
Responsible for monitoring data reports received from CS providers. Participate in internal and external meetings associated with CS
Document coordination efforts in appropriate systems and communicate outcomes of interventions with referring providers and other departments, such as Case Management, within expected time frames.
Make referrals to other CenCal departments for necessary involvement, i.e., Pharmacy, Care Coordination, Disease Management, Health Education, Population Health, and Member Services, as appropriate or as requested by the Community Supports Program Manager.
Active participation and support to the department's compliance and quality activities
Adhere to all CenCal Health Policies and Procedures and meet required performance standards
Other duties as assigned

Qualifications

Knowledge/Skills/Abilities

Required:

• Must demonstrate complete knowledge, understanding and possess a high level of skill set and proficiency with Microsoft Office Suite including Outlook, Word, and Excel
• Coordination skills relating to Care Management requests and the understanding of basic principles and practices for appropriate hand-offs and follow through with clinical teams.
• Must have extensive knowledge of Medi-Cal eligibility related issues, DSS, SSA, TCRC inter-workings, and an understanding of the State's beneficiary assignment and processes as they relate to the Plan
• Excellent and effective oral and written communication skills, including Member coaching skills and strong interpersonal skills;
• Must demonstrate, upon completion of orientation and training modules, a thorough understanding of CenCal's various healthcare program benefits and applicable co-payments, eligibility, coordination with the local government and CBO agencies, pharmacy formulary, and provider network
• Must possess a positive attitude and contribute to the success of the department and team
• Strong ability to work effectively under pressure and independently with minimal supervision
• Ability to manage multiple priorities and assume special projects over and above assigned responsibilities.

Preferred:

• Bilingual (English/Spanish)

Education and Experience

• Undergraduate degree in public health, psychology, social work, counseling or four (4) years experience in managed care, Social Services, Public Administration, Human Services, Behavioral Health, Home Health Department, or related environment working directly with underserved communities, mentally ill, working poor population, and/or persons with disabilities.
• Experience with case management, care coordination, or coordinating patient needs in a medical setting.
• Experience using solution-based strategies to support members/patients.