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Role Description

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

The Care Navigator Transitions of Care- CareBridge is responsible for ensuring that appropriate member treatment plans are followed on less complex cases and for proactively identifying ways to improve the health of our members and meet quality goals.

• Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
• Assesses member compliance with medical treatment plans via telephone or through on-site visits.
• Identifies barriers to plan compliance and coordinates resolutions.
• Identifies opportunities that impact quality goals and recommends process improvements.
• Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
• Coordinates identification of and referral to local, state or federally funded programs.
• Coaches members on ways to reduce health risks.
• Prepares reports to document case and compliance updates.
• Establishes and maintains relationships with agencies identified in appropriate contract.

Qualifications

• Requires a H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.
• For Carelon - CareBridge business unit, bilingual or multi-language skills may be required.

Requirements

• Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
• Bilingual candidates preferred.
• Strong oral, written and interpersonal communication skills.
• Problem-solving skills, facilitation skills, and analytical skills.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources