Patient Care Navigator II, Enhanced Care Management (ECM)

Riverside, CA - USA

Monthly Salary: $ 23 - 27

Posted on: 15 hours ago

Vacancies: 1 Vacancy

Job Summary

Description

The Patient Care Navigator II is a role that blends care coordination responsibilities with community engagement. This role supports the Cal AIM Enhanced Care Management (ECM) program and maintains an assigned caseload. Patient Care Navigator II provides care coordination connection to medical behavioral health and social services and ongoing engagement to support members needs.

The Patient Care Navigator II works closely with RN Care Managers (RNCM) Licensed Vocational Nurses (LVNs) Behavioral Health Care Managers (BHCM) Community Health Workers (CHWs) Health providers and community partners to ensure appropriate access to care.

FLSA Status	Exempt	Salary Range	$23.00-$27.00
Reports To	ECM Program Manager / Director	Direct Reports	No
Location	Riverside CA Onsite	Travel	Up to 80%
Work Type	Regular	Schedule	Full Time

Position Description:

Care Coordination & Caseload Management

Maintain an assigned caseload of ECM Members in accordance with Medi-Cal guidelines Provide ongoing outreach engagement and follow-up with members via phone and in-person visits based on assigned tier level and member need
Conduct face-to-face visits as required by member risk tier
Provide care coordination support including appointment scheduling transportation arrangements referral tracking and follow-up
Ensure smooth transitions of care including coordination with hospitals and facilities related to admissions and discharges
Engagement & Member Support
Utilize motivational interviewing to engage members in care
Connect members to community resources and social services including housing food transportation and other identified needs
Promote member self-efficacy and shared decision-making in care planning
Clinical Collaboration & Team Support
Collaborate with RNCMs LVNs BHCMs CHWs and other care team members regarding members care needs
Support care team members with delegated clerical tasks as appropriate
Program Operations & Documentation
Assign members to appropriate Case Managers based on risk category and available clinical data
Track and ensure completion of required assessments and screenings including Health Assessments and Shared Care Plans
Maintain timely accurate documentation in the ECM care management platform in compliance with program requirements

Additional Responsibilities

Attend meetings with providers health plans community partners and internal stakeholders
Complete additional tasks and projects assigned to support ECM program goals

Qualifications:

High school diploma or equivalent required; Associates or bachelors degree in health administration Public Health Social Work Sociology Psychology or related field preferred
Experience in care coordination community health work case management or social services
Experience working with high-risk or vulnerable populations
Strong interpersonal organizational and communication skills
Ability to manage a caseload and prioritize multiple tasks in a fast-paced environment
Comfortable with field-based community and home visits
Proficiency with electronic health records and care management platforms
Reliable transportation with active insurance coverage
Preferred Qualifications
Experience working within CalAIM ECM managed care or Medicaid programs
Knowledge of community-based resources and social service systems
Bilingual abilities preferred

Benefits:

As a firm passionate about health care were deeply committed to the health and wellness of our own team members. We offer comprehensive affordable insurance plans for our team and their families and a host of other unique benefits such as a yearly stipend for wellness-related activities and a paid parental leave program. You can learn more about our benefits offerings here: COPE Health Solutions
COPE Health Solutions is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise experience proven tools and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers health plans and self-insured employers. For more information visit .

To Apply:

DescriptionThe Patient Care Navigator II is a role that blends care coordination responsibilities with community engagement. This role supports the Cal AIM Enhanced Care Management (ECM) program and maintains an assigned caseload. Patient Care Navigator II provides care coordination connection to me...

Description

FLSA Status	Exempt	Salary Range	$23.00-$27.00
Reports To	ECM Program Manager / Director	Direct Reports	No
Location	Riverside CA Onsite	Travel	Up to 80%
Work Type	Regular	Schedule	Full Time

Position Description:

Care Coordination & Caseload Management

Maintain an assigned caseload of ECM Members in accordance with Medi-Cal guidelines Provide ongoing outreach engagement and follow-up with members via phone and in-person visits based on assigned tier level and member need
Conduct face-to-face visits as required by member risk tier
Provide care coordination support including appointment scheduling transportation arrangements referral tracking and follow-up
Ensure smooth transitions of care including coordination with hospitals and facilities related to admissions and discharges
Engagement & Member Support
Utilize motivational interviewing to engage members in care
Connect members to community resources and social services including housing food transportation and other identified needs
Promote member self-efficacy and shared decision-making in care planning
Clinical Collaboration & Team Support
Collaborate with RNCMs LVNs BHCMs CHWs and other care team members regarding members care needs
Support care team members with delegated clerical tasks as appropriate
Program Operations & Documentation
Assign members to appropriate Case Managers based on risk category and available clinical data
Track and ensure completion of required assessments and screenings including Health Assessments and Shared Care Plans
Maintain timely accurate documentation in the ECM care management platform in compliance with program requirements

Additional Responsibilities

Attend meetings with providers health plans community partners and internal stakeholders
Complete additional tasks and projects assigned to support ECM program goals

Qualifications:

High school diploma or equivalent required; Associates or bachelors degree in health administration Public Health Social Work Sociology Psychology or related field preferred
Experience in care coordination community health work case management or social services
Experience working with high-risk or vulnerable populations
Strong interpersonal organizational and communication skills
Ability to manage a caseload and prioritize multiple tasks in a fast-paced environment
Comfortable with field-based community and home visits
Proficiency with electronic health records and care management platforms
Reliable transportation with active insurance coverage
Preferred Qualifications
Experience working within CalAIM ECM managed care or Medicaid programs
Knowledge of community-based resources and social service systems
Bilingual abilities preferred