RN Senior Transition Navigator - Hybrid

Centene Corporation; Connecticut; Hybrid; USD 42,000 - 76,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Transition of Care Navigator to oversee the coordination of transitions for community members, working with care teams to develop effective plans and educate enrollees on services and requirements during transitions.

The role includes in-person and telephonic outreach with weekly to monthly field visits, collaborating with providers to ensure timely authorizations, and contributing to process improvements for transition of care.

Qualifications

• Requires a Bachelor’s degree and 4 – 6 years of related experience.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

• Works with care coordination team, providers, and/or other health care team members to develop an effective transition plan for members in the community
• Assists with the transition of care for members in the community based on enrollment or transition of care for services identified
• Works with care coordination and care management team to identify new member enrollees requiring transition services
• Ensures existing authorizations are honored during the transition process and works with care management team and providers to address any issues
• Acts as an available resource for members and their families and/or caregivers to educate on services, requirements, limitations, and/or exclusions of services as a result of transition planning
• May review transition metrics including new member assessments, volume of members transitioning into or out of care to identify trends and process improvements, and ensures all transition of care information is appropriately documented
• Partners with leadership to identify process improvements for transition of care for members and provides recommendations
• Assists with developing education materials and resources for members on requirements, limitations, or exclusions of services for transition of care
• Assists with developing education and training programs for care coordination staff and providers to improve transition of care services for members
• May evaluate the needs of the member, the resources available, and recommends and facilitates the plan for the best outcome
• May coordinate as appropriate between the member and/or family/caregivers and the care provider team to ensure members are being effectively treated
• Interacts with healthcare providers as appropriate to facilitate member care coordination needs
• Performs other duties as assigned
• Complies with all policies and standards

Skills

Care coordination

Education to patients

Education

Bachelor’s degree

4–6 years related experience

Job description

Centene Corporation is seeking a Transition of Care Navigator to oversee the coordination of transitions for community members, working with care teams to develop effective plans and educate enrollees on services and requirements during transitions.

The role includes in-person and telephonic outreach with weekly to monthly field visits, collaborating with providers to ensure timely authorizations, and contributing to process improvements for transition of care.