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

Independence Blue Cross, LLC; Philadelphia (Philadelphia County); Remoto; USD 50.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Fully remote

Tri-State Area (DE/NJ/PA)

Descrizione del lavoro

Independence Blue Cross, LLC is seeking an Autism Care Navigator to support families enrolled in the IBX Autism Case Management program. You will serve as single point of contact, coordinate referrals for diagnostic, ABA, and other care, and work with care managers to ensure timely access and positive member experiences across the Tri-State area.

This fully remote role emphasizes compassionate communication and thorough records management, with outreach to member families and collaboration

Competenze

• Bachelor's degree in Social Work, Psychology or related healthcare field with ≥3 years in health care or managed care.
• Strong computer and keyboarding skills with MS Outlook, Word, Excel, Adobe Acrobat, and data entry while on calls.
• Excellent written and verbal communication, interpersonal, and organizational skills.
• Basic understanding of diagnostic requirements and ability to make referrals for testing.
• Familiar with behavioral health/medical terminology.

Mansioni

• Provide information to inbound members and providers regarding Autism, ABA, and other mental health and substance use disorder benefits, resources, and policies.
• Make outreach calls to educate families about the Autism Case Management program and coordinate referrals.
• Collaborate with network providers to identify referrals for diagnostic, ABA, and specialty care.
• Provide follow-up calls to support information needed for the authorization process.
• Coordinate with lead Autism care managers, attend rounds and team meetings.
• Promote quality service delivery and effective care transitions for optimal member health outcomes.
• Coordinate with Network Operations to facilitate access to providers in the member's area.
• Facilitate communications including letters and faxes to members and providers to support department needs.
• Support families to reduce the burden of long-term disability.
• Provide administrative support to clinical staff and contribute to Utilization Management documentation.

Conoscenze

MS Outlook

MS Word

MS Excel

Adobe Acrobat

Data processing

Formazione

Bachelor's degree in Social Work, Psychology or related healthcare field

Strumenti

MS Outlook

MS Word

MS Excel

Adobe Acrobat

Descrizione del lavoro

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 wellbeing 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
• Facilitate communications including manual letters and faxes to members and providers to support department needs
• Promotes quality service delivery and reducing the burden member families face in dealing with a longterm 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 skillsBasic 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

• Selfmotivated 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 fastpaced, changing environment
• Ability to work within a collaborative, teamoriented 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 TriState 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.