• Pay Range - $25.00-$27.00/hr (Full-Time)

Job Summary

The role of Care Navigator is essential in supporting our goal to reduce unnecessary hospital readmissions by visiting & engaging admitted members in person, addressing post discharge needs, and ensure seamless transitions of care discharge follow up. The Care Navigator is assigned to acute and post-acute facilities in the community and works team to build trust with patients and connect them to AbsoluteCare’s services and interventions.

Duties and Responsibilities

• Engage in person with admitted members in hospitals and healthcare facilities to engage & build lasting rapport and trust.
• Conduct CN screenings and identify gaps in care, post discharge risks, escalate to TCM or supervisor for clinical support.
• Actively participate in Huddles to provide member updates and handoffs to center or POD teams when appropriate
• Ask member or their designated support person reason they went to the hospital
• Facilitate access to member clinical information needs required by TCM or supervisor
• Complete delegated tasks and coordinate resources to address identified needs.
• Schedule and coordinate post discharge follow-up appointments with AbsoluteCare primary care physician, community-based nurse practitioner/PA based on risk level guidance
• Provide post discharge support through day 7 and escalate to TCM or Supervisor any emerging clinical needs
• Ensure member has post discharge ordered medications, DME/Oxygen/Hoe Health as ordered.
• Serve as a positive liaison between the members, healthcare providers/facilities, and AbsoluteCare care team and services.
• Document all interactions and tasks accurately and timely in AbsoluteCare care management system.
• Collaborate with AbsoluteCare’s interdisciplinary teams to support holistic, integrated, safe transitions of care to home or next level of care
• Maintain mobility and flexibility to work independently across multiple healthcare sites.
• Meet established Key Performance Indicators.
• The Care Navigator’s facility assignment may change and/or duties may be modified based on business needs.

Minimum Qualifications

• A minimum of 80% of this role’s time is spent onsite in hospitals, skilled nursing facilities and/or residential treatment facilities to engage members and build relationships with facility discharge planners and case management staff.
• High School diploma or equivalent
• CNA, Certified MA- preferred, or CHW with prior hospital experience required
• CPR/BLS certification required.
• 3+ years of experience in serving the needs of complex populations, in a patient facing healthcare environment. Preference given to qualified candidates with hospital experience and/or care coordination roles.
• Experience working in patient-facing roles in a SNF, hospital or physician office is required.
• Ability to complete screenings and delegated tasks as well as escalate findings to the clinical team where appropriate.
• Excellent communication skills and ability to quickly build rapport with members
• Experience with complex government-sponsored populations preferred, e.g., Medicaid, Medicare beneficiaries.
• Ability to take a creative and innovative approach to problem-solving to aid patients in overcoming barriers to care transitions.
• Excellent computer skills including Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) and electronic medical record documentation required.
• Excellent written and oral communication skills to interact with members, families, community stakeholders, and interdisciplinary team required.
• Ability to work independently.
• Active unencumbered driver’s license, with automobile insurance, reliable transportation, and ability to work in office and in the community.
• Second language ability is desirable relevant to local population, geography, resources.

Working conditions

This job operates in the community, hospitals, healthcare facilities and within a professional office environment.  This role requires reliable transportation to commute back and forth between inpatient facilities and office; and routinely uses general office equipment.

Physical requirements

• Ability to communicate clearly and exchange accurate information consistently.
• Ability to remain stationary for long periods of time.
• Repetitious movements.
• Constantly operates computer, keyboard, copy and fax machine, phone, and other general office equipment.

• Ability to occasionally move objects up to 20 lbs.

Direct reports

None.