Care Navigator - Remote in Colorado ONLY

Western-Healthcare-Alliance; Grand Junction (CO); Remote; USD 34,000 - 43,000; Full time

Benefits offered by this job

Medical - Low premium cost and plan 옵션

Dental - Delta Dental

Vision – VSP

401k with 5% company match

Flexible Spending Account (FSA)

7 Paid Holidays

Paid Time Off

Sick Leave

Life and Long-Term Disability

Employee Assistance Program

Pet Insurance

Group Discounts

Job summary

Western Healthcare Alliance is seeking a Care Navigator to support the care coordination program across Medicare/Medicaid populations. The role works with an interdisciplinary team, conducting outreach, collecting and reviewing health data, and guiding patients through the care continuum to improve outcomes.

Remote work is available for Colorado residents, with a focus on culturally competent communication, documentation in EHRs, and collaboration with clinicians and community partners to reduce

Qualifications

• Two (2) years progressive related experience in a healthcare setting preferred.
• Bachelor’s degree or related certification preferred; combined education/experience acceptable.
• Knowledge of health education, motivational strategies, and serving underserved populations.

Responsibilities

• Work collaboratively to support individualized care plans addressing physical, behavioral, and social needs.
• Provide outreach, disease management, education, and other needed clinically based activities to patients and referral sources.
• Coordinate referrals to medical, behavioral health, social, and community resources to reduce barriers to care.
• Conduct assessments and ongoing reassessments to identify changing health and social needs.
• Communicate with care team members to ensure plans of care are followed and updated.

Skills

Population Health Management

Care Coordination

Interpersonal Communication

Education/Coaching

Health Insurance Knowledge

Community Resource Knowledge

Research & Evaluation

Education

Bachelor's degree in related field

Related certification (MA, CNA, LPN)

Tools

Microsoft Teams

Excel

Word

Job description

Location: Remote - Colorado Only

Position Pay Range: $24.75 - $31.06 per hour

Employees who meet the position’s bilingual qualification requirements are eligible for an additional $2.00 per hour.

Department: Community Care Alliance

Reports to: Manager of Care Coordination

Excellent Benefits Include:

• Medical - Low premium cost and multiple plan options to best fit your needs.
• Dental - Delta Dental
• Vision – VSP
• 401k with 5% company match!
• Flexible Spending Account (FSA) to help you save on healthcare and dependent care expenses
• 7 Paid Holidays during the year
• Paid Time Off: accrue 3 weeks your first year; 4 weeks after year 5; and more each year after!
• Sick Leave: Up to 6 Days accrue each year.
• Employer Paid Life and Long-Term Disability Plans, with options to purchase additional coverage
• Employee Assistance Program for you and members of your household
• Pet Insurance
• Access to Group Discounts including mobile phone, rental cars, and more!

If your experience doesn’t perfectly match every requirement, we’d still love to hear from you!

Summary

The Care Navigator position supports the work of the care coordination program, navigating care within assigned populations as determined by CCA (Medicare, Medicaid, etc.). This position functions as part of an interdisciplinary team. Responsibilities are performed in alignment with the scope of practice, payer requirements, and organizational policies. Responsibilities will be carried out by organizing, collecting, reviewing, and reporting health and social information through phone outreach, while demonstrating multicultural sensitivity and effective communication skills with members. This position follows established safety protocols in the community setting, as well as established preventive and disease management programs for health promotion and education. Deliver culturally appropriate information regarding the availability of health and community resources that will reduce barriers to care. This position will work to improve the quality of life for enrolled patients by supporting quality outcomes, facilitating smooth care transitions, coordinating care across the health continuum, and encouraging healthy lifestyle choices to reduce the long-term effects of chronic illness. This position is accountable for working with and representing our organization across multiple constituents.

Essential Responsibilities

• Work collaboratively to support individualized care plans addressing physical, behavioral, and social needs.

• Work collaboratively with clinic staff to provide education and recruitment techniques.
• Exhibit competence in the Seven Domains of Care Coordination in the primary care setting:
  • Population Health Management,
  • Comprehensive Assessment and Care Planning,
  • Interpersonal Communication,
  • Education/Coaching,
  • Health Insurance and Benefit knowledge,
  • Community Resource knowledge and
  • Research and Evaluation skills.
• Provide outreach, disease management, education, and other needed clinically based activities to patients managing various chronic health conditions and to referral sources and the community.

• Coordinate referrals to medical, behavioral health, social, environmental, and community-based resources to reduce barriers to care.
• Conduct assessments and ongoing reassessments to identify changing health and social needs.

• Assess and identify participants’ readiness, willingness, and ability to change.
• Identify patient coaching, support, and educational needs by focusing on what is important to their quality of life.
• Determine and connect with relevant community and/or health care resources to support solutions; provide educational tools to promote self-management.

• Conduct health and wellness coaching sessions to assist participants in making lasting changes to their health and wellness.
• Monitor and document the patient’s progress toward his or her optimal level of wellness.
• Promote wellness and provide education regarding preventative care measures.
• Act as a liaison between referral sources, facilities, and outside entities to prevent and/or resolve a continuum of care issues
• Communicate with service delivery partners, providers, and other health professionals to provide care coordination to ensure the plan of care facilitates the efficient use of health care resources.
• Demonstrate skills in effectively coordinating and monitoring care to promote quality and cost-effective outcomes.
• Proactively follow up with patients discharged from all hospitals, rehab facilities, and emergency rooms to recruit patients into the care management services to ensure the patient has an appointment with their provider and reviews any unmet needs prior to the upcoming appointment.
• Analyzes clinical data from EHR/Registry systems to identify patients with care gaps and uses risk stratification metrics to support care coordination recruitment.

• Communicate identified issues requiring intervention to appropriate care team members, providers, and departments.

• Assist clinics with billing questions related to services provided by the Regional Care Coordinator.
• Remains current on industry trends, best practice operational models, and changing patient and provider needs.
• Collaborate across various platforms for documentation and be familiar with, including but not limited to, Microsoft Teams, Excel, and Word.

EDUCATION and/or EXPERIENCE

• Two (2)years ofprogressive relatedexperience working with diverse populations. Healthcare setting experience preferred.
• Bachelor’s degree in related field and/or related certification (MA, CNA, LPN) preferred. Or the combination of education and experience that would enable performance of the full scope of the position.
• Knowledge of health education, motivational strategies, and an empathetic manner working with the underserved. Knowledge of healthcare business preferred.Knowledge of local area preferred.

About Western Healthcare Alliance (WHA)

Western Healthcare Alliance (WHA) began in 1989 when a small group of rural Colorado hospitals decided that there was power in numbers. Today, WHA celebrates over 30 years of collaboration with healthcare members in Colorado, Utah, and Michigan. A subset of WHA members own Healthcare Management, a sister company of WHA, which provides revenue cycle solutions to healthcare entities. Developing and managing a menu of member-owned and partner programs, WHA saves members money that helps them remain sustainable and viable in their communities.

About WHA’s Community Care Alliance (CCA)

The Community Care Alliance (CCA) was formed in 2015 by Western Healthcare Alliance to serve members as they embarked on the journey towards alternative payment models and population health. Today, the CCA serves as a Clinically and Financially Integrated Network (CFIN) for value-based contracting. Our CFIN is a partnership of providers and hospitals collaborating to receive reimbursement based on high-quality, low-cost care.

Our culture is important and ensuring we have the right staff is critical. We encourage employee growth, provide learning opportunities, and often promote from within. Are you dependable, empathetic, and have an excellent work ethic? If so, you might be a good fit for us!

Colorado requires an estimated closing date for job postings. Please don’t be discouraged from applying if you see this date has passed.