Customer Care Navigator, ABA services - remote (PA/NJ/DE)

Independence Blue Cross, LLC in; Philadelphia (Philadelphia County); Remote; USD 52,000 - 76,000; Full time

Job summary

Independence Blue Cross is seeking a Customer Care Navigator for ABA services. This fully remote role supports families in the Tri-State Area (PA/NJ/DE) with Autism Case Management.

You will educate families, coordinate referrals, and assist with the authorization process while working closely with Autism care managers to ensure positive member experiences. The ideal candidate holds a Bachelor's in Social Work, Psychology, or related field, with 3+ years in healthcare or managed care, strong

Qualifications

• Bachelor's degree in Social Work, Psychology or related healthcare field.
• 3+ years of experience in health care or managed care setting.
• Familiarity with behavioral health terminology and autism-related care.

Responsibilities

• Provide information to inbound members and providers about Autism, ABA, and benefits.
• Make outreach calls to educate families about Autism Case Management and referrals.
• Coordinate with Autism care managers for member and family care needs.
• Identify referrals for diagnostic, ABA, and specialty care with network providers.
• Follow up calls to support authorization processes and documentation.
• Collaborate with lead Autism care managers in rounds and team meetings.

Skills

Excellent communication

Organization

Assessment skills

Multitasking

Education

Bachelor's degree in Social Work or psychology

Tools

MS Outlook

MS Word

MS Excel

Adobe Acrobat

Job description

Customer Care Navigator, ABA services - remote (PA/NJ/DE)

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

The Autism Care Navigators provide support for families with children served by the IBX Autism Case Management team. The ACNs are responsible for serving as a single point of contact for families, ensuring accurate and viable referrals for diagnostic, ABA and other care, outreaching member families, screening for behavioral and medical care management needs, assessing for and providing community resources, educating members regarding benefits and authorization process, coordinating with Autism care managers to ensure support positive member experience, other responsibilities as assigned.

ESSENTIAL FUNCTIONS

• Provide information to inbound members and providers callers regarding Autism, ABA , and other mental health and substance use disorder benefits, community resources, care management programs and services, policies and procedures
• Responsible for making outreach calls to member families to educate them around the Autism Case management program, screen for any care management or referrals, support program document collection, and coordinate with the care managers on member and family care needs,
• Collaborate with network providers to identify appropriate referrals for diagnostic, ABA and specialty care
• Provide follow up calls to support appropriate information needed for authorization process
• Coordinates with lead Autism care managers to address identified member and family care needs including attending rounds and team meetings.
• Promote quality service delivery and effective care transitions planning for optimal member health outcomes
• Coordinate with Network Operations staff to facilitate access to providers in the Member's area
• Promotes quality service delivery and reducing the burden member families face in dealing with a long-term disability
• Provides administrative support services to clinical staff and in support of coordinated care and positive care outcomes such as building cases in system to begin Utilization Management process.

Qualifications

• Bachelor's degree in Social Work, Psychology or related healthcare field and three (3) or more years of experience in a health care, or managed care setting
• Strong computer and keyboarding skills (MS Outlook, MS Word, MS Excel, Adobe Acrobat, and data processing), including the ability to document while simultaneously while taking information over the phone
• Excellent written and verbal communication, interpersonal, and organizational skills
• Excellent assessment and engagement skills
• Basic understanding of diagnostic requirements
• Ability to make referrals for testing
• Basic understanding of medical comorbidities
  • Familiar with behavioral health/medical terminology

PREFERRED

• Bachelor's degree and five (5) or more years of experience in a health care, managed care setting
• Experience working with members with autism or other developmental disabilities and their families
• Bilingual (English and Spanish)

KEY ATTRIBUTES

• Self-motivated and the ability to assume a collaborative role in ensuring that all objectives are met
• Ability to work independently to meet team objectives/goals
• Professional demeanor in response to all situations regardless of the nature or circumstances of the situation
• Able to manage multiple tasks in a fast-paced, changing environment
• Ability to work within a collaborative, team-oriented environment

Fully Remote:
This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence’s physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.