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Care Navigator Jobs
Company | Covenant Health |
Address | Knoxville, TN, United States |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-08-18 |
Posted at | 9 months ago |
Care Navigator - Chronic Care Managment
- Assesses, identifies and prioritizes individual needs and builds rapport and trust with patients.
- Maintains effective communication with payer care coordination team to collaborate on patient care initiatives and care management strategies.
- Maintains continuity of care among care coordination team members by documenting and communicating actions, opportunities and continuing needs.
- Serves as a liaison between practice and insurance payors concerning the care and treatment options of certain patients with chronic health conditions.
- Facilitates patient understanding of the physician’s treatment plan, including but not limited to, prescriptions, prescription refills, medical supplies, referrals, authorization of services, and when to seek care.
- Performs assessment of the patient and/or family to further assess social, emotional, functional and physical health status.
- Responsible for understanding, assisting, educating and facilitating the maintenance and promotion of preventative care of a chronic patient including promotion of preventative screenings, lifestyle coaching, and on-going follow up care.
- Provides education to providers, office managers and other clinic staff relating to quality initiatives and clinical documentation improvement.
- Demonstrates knowledge of payer contracts including required quality metrics and available payer resources to assist in care coordination efforts.
- Assures evidence-based practice guidelines are incorporated in to patient’s plan of care.
- Promotes education by supplying informational materials, directing the patient to the appropriate agencies and facilities in the community for care.
- Assists in the coordination of transitions in care for designated patient populations.
- Demonstrates knowledge of HEDIS, HCC’s and Medicare Risk Adjustment and their impact on pay-per-performance contracts.
- Reviews and assesses the member’s available data, including clinical history, outpatient/inpatient treatments, emergency room visits, medications, chart reviews, or other information, to assist in monitoring and facilitation of adherence to prescribed care plans.
- Monitors care processes to provide cost-effective implementation and evaluation of utilization management and patient care initiatives.
- Responsible for understanding, assisting, educating, and facilitating the overall plan of care of patients with chronic conditions.
- Responsible for carrying out key functions related to patient outreach, quality reporting, performance measurement, and acting as a key liaison between physician and patient.
- Collaborates with the patient and provider regarding opportunities for optimizing care and closing gaps.
- Performs outreach functions, as necessary, to patients that have been identified as having chronic conditions that meet eligibility requirements for their program.
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