Remote Member Care Navigator – Health Access & Gap Closure

Automatic Data Processing, Inc.; Cary (NC); Hybrid; USD 40,000 - 65,000; Full time

Benefits offered by this job

Competitive benefits package

Growth and bonus incentives

Job summary

Community Care of North Carolina is seeking a full-time Member Care Coordinator in Cary, NC. The role collaborates with Care Management staff to support patient care by closing care gaps, reducing hospitalizations, and improving access to resources across the state.

The position may be remote within regions or on-site at CCPN practices, requiring strong data systems knowledge, excellent communication, and the ability to navigate multiple EHRs.

Qualifications

• High school diploma or GED required
• 2-4 years minimum experience in a health care setting required
• 2 or 4-year degree in health-related field preferred

Responsibilities

• Receive and document all referrals from various sources into the Care Management documentation platform
• Outreach, engagement, and scheduling of members for Care Managers
• Verify eligibility and demographic information
• Complete appropriate screenings as needed
• Assist with mailing educational materials, consent forms or other documents to the member as necessary
• Assist with referrals on behalf of the Care Management or program team
• Provide information for access and coordination of resources
• Assist member with care coordination and health care system navigation
• Provide culturally appropriate health education and information
• Advocate for members
• Identify care gaps and outreach to members to close gaps as requested
• Assist practice to submit supplemental data to health plans to provide documentation of gap closure as requested; assist with scheduling medical appointments and transportation as needed
• Assist with pulling Care Gap/Recommended Actions/High Risk reports
• Assist in addressing Social Determinants of Health as needed
• Access multiple EHRs to obtain and upload documents into the care management platform
• Meet productivity and role expectations as defined
• Collaborate with the Care Team to address barriers and create efficiency with processes
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded
• Abide by department guidelines, company policies, and HIPAA regulations
• Attend Departmental and corporate meetings, local and regional trainings, or other events as required
• Understand and uphold CCNC goals, objectives, and standards

Job description

Community Care of North Carolina is seeking a full-time Member Care Coordinator in Cary, NC. The role collaborates with Care Management staff to support patient care by closing care gaps, reducing hospitalizations, and improving access to resources across the state.

The position may be remote within regions or on-site at CCPN practices, requiring strong data systems knowledge, excellent communication, and the ability to navigate multiple EHRs.