Clinical Care Navigator- RN
Clinical Care Navigator- RN
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Job Description
Summary/Objective:
Curative wants to change the view on what a health plan can be. Born out of the pandemic we created a health plan reinvented for a postpandemic world that is built around wholeperson affordable preventive care featuring more benefits. $0 copays and $0 deductibles when members complete the Baseline Visit within 120 days of enrollment into the Plan. The Population Health Team is responsible for driving improved health outcomes leveraging a datafirst mindset to help our members achieve their optimal health wellbeing. Within the Population Health team Clinical Care Navigators work very closely with the Care Navigation team and are at the core of the Curative memberoriented health plan. Our Clinical Care Navigators serve as a central point of contact to handle our most clinically complex members and members that want assistance in achieving their health goals.
Essential Functions:
- Serve as a Clinical Care Navigator working to coordinate the patients plan of care with caregivers and providers
- Facilitate the achievement of client wellness and autonomy through advocacy assessment planning communication education resource management and service facilitation
- Collect and assess member information pertinent to a members history condition and functional abilities in order to develop a comprehensive individualized care management plan that promotes appropriate utilization and costeffective care and services
- Based on the needs and values of the member and in collaboration with all service providers the Clinical Care Navigator links members with appropriate providers and resources throughout the continuum of health and care settings while ensuring that the care provided is safe effective clientcentered timely efficient and equitable
- Clinical Care Navigator has direct communication with the member care providers and other service delivery professionals. The Clinical Care Navigator is able to enhance these services by maintaining the clients privacy confidentiality health and safety through advocacy and adherence to ethical legal accreditation certification and regulatory standards or guidelines
- Coordinates with Care Navigators (nonlicensed staff) on an ongoing basis to maximize the educational outreach to members through established workflows and processes
- Participates in supporting new Curative programs and their implementation.
- Participation with clinical team meetings and/or conferences as appropriate and assigned
- Consistently meets established performance metrics and contractual obligations
- Consistently review and abide by Curative policies and procedures
- Other duties as assigned to support team
Qualifications
Education:
- Graduate of an accredited nursing program with current RN licensure in good standing
- Preferred: Certified Case Manager (CCM) Certified Managed Care Nurse (CMCN) or other relevant certifications
- Preferred: Bachelor of Science in Nursing degree (BSN)
Experience:
- At least 2 years minimum experience working as a Case Manager in a health plan setting
- Background in managed care experience working with vulnerable populations who have acute chronic or complex psychosocial needs
- Preferred: experience working in a startup environment
Skills:
- Ability to be nimble and work in a fast paced and changing environment
- Current knowledge of services provided across the continuum of care that involve multiple systems addressing the ongoing needs of members
- Knowledge of discharge planning and transitions of care is essential
- Familiarity with community agencies and with how to make appropriate referrals to them
- Excellent verbal and written communication skills
- Excellent computer skills (we use Google suite)
- Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications
- Preferred Bilingual Fluent in Spanish and English (verbal and written communication)
Work Environment:
- This job operates in a remote environment with the need to have a reliable internet and phone connection
- Must have a quiet place secure with no distractions to perform duties for work from home
- Must have password protected stable internet access stipend will be provided
- Work location MUST be secure and private to maintain HIPAA compliance for work from home
- Office equipment will be supplied including: PC monitor keyboard mouse headset
- While performing the duties of this Job the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
- The employee is frequently required to reach with hands and arms.
- Specific vision abilities required by this job include close vision distance vision color vision peripheral vision depth perception and ability to adjust focus.
- We also request with the exception of emergencies that you do not request any time off within the first 120 days of employment. Any request within the first 120 days if approved will be unpaid
Position Type/Expected Hours of Work:
This is a fulltime salaried remote position. Typical work hours are Monday through Friday 8:00 AM to 5:00 PM local time with flexibility as needed to support different time zones. Our headquarters are in Austin TX so we often operate on Central Time.
Travel:
No travel is expected with this role but may be optional for department offsites.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice.
Required Experience:
Senior IC
Employment Type
Full-Time
