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Care Navigator

Company: ICONMA
Location: Monterey Park
Posted on: January 13, 2021

Job Description:

Location: Monterey Park, CA/RemoteDuration:3 months with possible extension/ Possible contract to hireDescription:Serves as initial point of contact for providers and members in the medical management process by telephone or correspondence. Assists in ensuring members are effectively and efficiently managed through the medical/disease management process as needs require. Within extension of authority, assigns length of stay on acute inpatient admissions, as well as approves specific home health, DME. Process authorization requests and facilitates referrals. Assists with system letters, requests for information and data entry. Provides administrative/clerical support to medical and disease management.Job Requirements:Responsibilities:- Entry level intake (faxed in auth's, calls left on voicemail)- Select support for Case Manager such as mailings, surveys.- Data entry including authorization forms, high risk member information, verbal HIPPA authorizations, and SNF admissions- Specified template letters for CM- Create family files- Specified callbacks- Assist HMO with IPA mail authorization forms- Mail HIPAA forms to members- Support to Senior/Lead HCS- Responds to inquiry calls on a limited basisQualifications:- Understanding of basic Case Management principles to refer members for management of clinical and psychosocial problems- Understanding of basic member engagement principles, techniques and practices and their application to complex social and clinical problems- Knowledge of the provisions and eligibility terms for Cal MediConnect, Medi-Cal and Medicare Programs and Benefits- Skill in establishing effective working relationships with Members- Knowledge of CMS and DHCS regulations- Knowledge base on specific health issues and medical terminology- 2-3 years working in a managed care environment preferred- Preferred bilingual Spanish and English- Must have strong computer skills and proficiency with Microsoft Office- Must be able to communicate effectively both orally and in writing- Must be able to communicate with all levels of the Care1st staffEssential duties and responsibilities:- Provide welcome and their contact information to new members- Contact members as required to meet program guidelines- Assist members with access to primary and preventive care- Perform health risk screenings based on members risk and according to regulations- Ensure coordination of benefits and continuity of care issues are addressed- Encourage member participation in obtaining applicable HEDIS preventive measures and coordinate appointments as needed- Provide information on strategies and behaviors for wellness and prevention- Coordinate culturally competent care- Attend ICT meetings as requiredAdditional Information: Bilingual - Spanish/English is a must haveWants someone with medical background - Medical assistance, doctors office, healthcare knowledgeCustomer care background is helpful2 years' experience in health plan or medical group or office background- Medical plan background - medical terminology is helpful- Medical, Medicare, benefit information- Communication skills - previous assistance with membersAs an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability

Keywords: ICONMA, Monterey Park , Care Navigator, Other , Monterey Park, California

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