Dual-Eligible Community Care Navigator

CareSource; Michigan; On-site; USD 63,000 - 100,000; Full time

Job summary

CareSource is seeking a Community Based Care Manager to coordinate care for dual-eligible beneficiaries across community-based settings in Michigan. The role emphasizes integrating health services with community resources to improve outcomes and reduce hospital readmissions.

Responsibilities include comprehensive assessments, developing individualized plans with ICT, educating members about Medicare/Medicaid benefits, and coordinating with providers while maintaining thorough records.

Qualifications

• Nursing degree from an accredited nursing program required or Bachelor's degree in a health care field required.
• Equivalent years of relevant work experience may be accepted in lieu of required education.
• Previous experience in nursing, social work, counseling or health care profession required.
• Case management or care coordination experience with dual-eligible populations preferred.
• Medicaid and/or Medicare managed care experience preferred.

Responsibilities

• Engage member in community-based settings to establish care coordination relationships.
• Liaise between providers, resources, and dual-eligible beneficiaries to ensure seamless care.
• Conduct comprehensive assessments of physical, mental, and social needs.
• Develop and implement individualized care plans with interdisciplinary care team.
• Assist members in accessing housing, transportation, and social services.
• Educate members about benefits, managing chronic conditions, and preventive care.
• Monitor health status and adjust care plans; follow up after hospitalizations.
• Coordinate with providers to avoid duplication of services.
• Maintain accurate records and collect data to evaluate effectiveness.
• Travel as needed; adhere to NCQA and CMSA standards.

Skills

Microsoft Office

Interpersonal skills

Communication skills

Case management

Decision making

Education

RN license

LCSW/CSW or clinical counselor license

Bachelor's degree in health care

Job description

CareSource is seeking a Community Based Care Manager to coordinate care for dual-eligible beneficiaries across community-based settings in Michigan. The role emphasizes integrating health services with community resources to improve outcomes and reduce hospital readmissions.

Responsibilities include comprehensive assessments, developing individualized plans with ICT, educating members about Medicare/Medicaid benefits, and coordinating with providers while maintaining thorough records.