CLINICAL SERVICES CARE NAVIGATOR in Kapolei, HI at Beacon Health Options

Date Posted: 5/20/2018

Job Snapshot

Job Description

We are currently seeking a dynamic CLINICAL SERVICES CARE NAVIGATOR to join our team at our office in Kapolei. The Care Navigator is responsible for supporting the members with behavioral health needs by:

• Outreaching to members in the comunity

• Explaining to members about the service coordination (SC) or case management (CM) program

• Engaging members with behavioral health needs in SC or CM

• Expediting access for members to services

• Rapid response to provider/member needs in community based settings and inpatient levels of care.

• Ensure continuity and integration of services between all parties

• Work collaboratively with Service Coordinators, Case Managers, and Team Leads

Care Navigator must have a strong knowledge of the local community and must be comfortable working with members with serious mental illness (SMI) in a community based setting. Care Navigators provide only case management service, they are not direct clinical service providers and do not conduct utilization review nor do they issue authorizations to providers.

Position Responsibilities:

  • Provide continuum of quality care through telephonic and field based outreach, education, crisis intervention and other clinically based activities to plan members as specified in their treatment plans.
  • Assist Case managers and Service Coordinators with the development of case management and crisis plans for medical treatment and/or behavioral modification within the scope of practice.
  • Coordinates, with oversight by Case Managers and Service Coordinators, all information and referral functions from those calls including initiation of care plans to ensure continuity and integration of services.
  • Maintains logs and other data bases regarding care coordination activities.
  • Track aftercare outpatient appointments following inpatient or acute levels of care of assigned caseload.
  • Assist members in accessing care by educating providers, members and providing/arranging transportation as necessary.
  • Identify individual limitations, deficits, and strengths and aggressively attempt to provide patients with what they need in relation to medical, behavioral and social needs.
  • Help reduce the negative consequences to the individual when there is a lack of follow up and participation in treatment.
  • Participate in monthly meetings to discuss feedback from providers/members re: our continuum of care. Additionally, assist in identifying gaps in covered services.
  • Obtain signed releases of information from members via on site collaboration with providers
  • Performs special projects and other duties as assigned and required.

Position Requirements:

Education:

  • Associate’s degree or higher in a health related field

Knowledge, Skills & Abilities:

  • Two or more years’ experience in a clinical support environment required.

  • Experience in managed care setting or insurance company preferred.

  • Knowledge of medical terminology preferred.

  • Familiarity with role of Managed Behavioral Care organization in mental health & substance abuse treatment.

  • Knowledge of levels of care and resources available for the treatment of mental health and substance abuse disorders.

  • Ability to complete telephonic assessments; distinguish emergency, urgent and routine situations for appropriate referrals.

  • Ability to interact with multi-disciplinary team.

TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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