Medicare/Medicaid Care Navigator

Insight Global; Dayton (OH); On-site; USD 60,000 - 90,000; Full time

Job summary

Insight Global is seeking a Community Based Care Coordinator to coordinate care for dual-eligible Medicare/Medicaid members in Ohio. The role involves assessing medical, behavioral health, functional, and social needs, and developing individualized care plans with a focus on collaboration across providers and community organizations.

Responsibilities include conducting home and community assessments, coordinating care transitions, and advocating for members.

Qualifications

• Must hold an Ohio clinical license (RN, social worker, or clinical counselor).
• Experience in healthcare settings and care coordination preferred.
• Ability to coordinate care across multiple providers and organizations.

Responsibilities

• Conduct comprehensive member assessments to identify medical, behavioral health, functional, and social needs.
• Develop, implement, and regularly update individualized care plans.
• Meet with members in homes, healthcare settings, offices, and community locations.
• Coordinate transitions of care and prevent readmissions after hospital events.
• Connect members with housing, transportation, food assistance, and other services.
• Maintain documentation and ensure compliance with NCQA and CMSA standards.

Skills

Care coordination

Interdisciplinary teamwork

Assessment skills

Education

Nursing license (RN)

Social Worker license

Clinical Counselor license

Job description

Insight Global is seeking a Community Based Care Coordinator to coordinate care for dual-eligible Medicare/Medicaid members in Ohio. The role involves assessing medical, behavioral health, functional, and social needs, and developing individualized care plans with a focus on collaboration across providers and community organizations.

Responsibilities include conducting home and community assessments, coordinating care transitions, and advocating for members.