TOC Care Navigator

HMSA; Honolulu (HI); Hybride; USD 60 000 - 75 000; Plein temps

Résumé du poste

HMSA in Honolulu seeks a Care Transition Coordinator to support safe member discharges and seamless care handoffs. You triage barriers, coordinate with TCNs and CHWs, and educate members and families about appointments and care plan requirements.

In this hybrid role, you collaborate with the healthcare team to schedule follow-ups, monitor progress, and address needs post-discharge, ensuring smooth transitions and access to community services.

Responsabilités

• Triage member to identify medical, psychological, and social barriers to discharge then transition member to appropriate healthcare professional on their team such as TCN or CHW.
• Work with healthcare team to ensure safe and smooth member transitions.
• Inform members and families about appointments and other care plan requirements.
• Schedule and monitor follow-up appointments with providers and community services.
• Track member progress and address needs through calls following call cadence; refers to TCN for medical needs and CHW for community needs.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

Description du poste

1. Assessment
   • Triage member to identify medical, psychological, and social barriers to discharge then transition member to appropriate healthcare professional on their team such as TCN or CHW.
2. Care Transition Collaboration
   • Work with healthcare team to ensure safe and smooth member transitions
3. Education
   • Inform members and families about appointments and other care plan requirements.
4. Follow-Up Coordination
   • Schedule and monitor follow-up appointments with providers and community services.
5. Post-Discharge Follow-Up
   • Track member progress and address needs through calls following call cadence
   • Refers to TCN for medical needs and CHW for community needs.
6. Performs all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid