[Hiring] Health Navigator - LPN @Capital Blue Cross

Role Description

The Health Navigator collaborates with members, family, healthcare providers, community resources, and other members of the healthcare team to coordinate services and address barriers including access to health care, health literacy, transportation, wellness, and gaps in care. The Health Navigator will guide members to achieve optimal and vibrant health by providing tools, information, and assistance to help understand their healthcare options, take control of their healthcare needs, bridge the current gap between social-economic and medical and behavioral needs, and navigate the otherwise often confusing steps along the path to efficient and effective care.

• Identifying, facilitating, and securing access to needed healthcare, social services benefits, and community resources.
• Assist members with navigating the steps along the path to efficient and effective care.
• Coordinate appointments with and transportation to physicians and non-physician providers to ensure timely and efficient delivery of diagnostic and treatment services when needed.
• Actively monitors incoming calls, conducts outgoing calls, and responds to voice mail requests in a timely manner.
• Identify and assess members’ medical, behavioral, social, emotional, and financial needs.
• Effectively and efficiently utilize available resources to connect at-risk members with appropriate community resources.
• Conduct health education.
• Build relationships with members, their families, and caregivers to support health care goals.
• Provide emotional support and/or refer to community-based or physician/provider for greater level of psychosocial intervention.
• Complete education to assigned members and engage them into programs.
• Complete surveys and assessments for assigned members to support health & wellness needs.
• Deliver education on condition-specific topics, medication adherence, preventive care guidance, and navigation of available health benefits.
• Collaborate with interdisciplinary teams to support whole-person care and improve quality outcomes.
• Identify and report quality of care issues in accordance with established policies and procedures.
• Document all care navigator activities in the care management documentation system.
• Assist with assigned population processes including retrieving and assigning referrals.

Qualifications

• Critical thinking and problem-solving skills; ability to handle critical situations.
• Excellent written, oral communication, listening, and organizational skills.
• Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products.
• Able to demonstrate strong customer service skills, including tact and diplomacy.
• Ability to appropriately prioritize workload and assignments.
• Ability to work autonomously and as part of an interdisciplinary team.
• Demonstrates sound judgment that affirms the rights and responsibilities of members, families, healthcare professionals, and organizations.

Requirements

• Knowledgeable on how to navigate all aspects of medical, behavioral, and social systems.
• Knowledge of NCQA standards for Population Health Management, DMAA standards for disease management, and CMSA Standards of Practice for Case Management.
• Knowledge of current and emerging medical treatment modalities and best practice guidelines.
• Knowledge of adult learning principles, motivational interviewing, and intrinsic coaching techniques.
• At least three (3) years’ recent/related experience working in health and wellness promotion, inpatient, or other appropriate clinical settings.
• Behavioral Health experience beneficial but not required.

Education and Certifications

• Patient Navigation certification preferred or obtained within 1-year of employment.
• Licensed Practical Nurse active license or degree in healthcare related field and 3 years of experience directly related to the duties and responsibilities specified.

Benefits

• Comprehensive benefits package including Medical, Dental & Vision coverage.
• Retirement Plan.
• Generous time off including Paid Time Off, Holidays, and Volunteer time off.
• Incentive Plan.
• Tuition Reimbursement.