Care Navigator

Position Title: Care Navigator

Work Location: Remote, TX

Assignment Duration: 6 months (Possibility to extend or convert)

Work Schedule: Hours of operation is 8-6:30 pm CST. We have 4 different shifts: 8:30-5, 9-5:30, 9:30-6, 10-6:30. Lunch break: 1 hour during training, once assigned shift 30 minutes & 2 15-minute breaks. OT potential - can support other departments with authorization.

Work Arrangement: Remote

Position Summary:

Health Plan Call Center. Would be working with MSC Department and assisting in taking calls for our STAR+PLUS member. Team is to cover and answer calls that come in through call center. This is to cover the SCs who are out in LOA, FMLA and the openings we have open.

Background & Context:

Self-starters, eager to learn, great customer service. Each day, they will interact with different members, learning from them and assisting with their individual needs.

Key Responsibilities:

• These positions work in a Call Center setting where the contractors are on a phone queue.
• Day to Day responsibilities - Inbound call center, assist and educate Medicaid members on benefits and Services such as PCP Changes, ID Cards and Coordinate transportation and other services.

Qualification & Experience:

• Required: HS Diploma
• Preferred: BUT NOT Required: BA in Social Work or Healthcare Mgmt, LVN, CNA, CMA, RT, Pharmacy Tech
• Over 5 years of experience working directly with the ABD (Aged, Blind, and Disabled) population in call center environments, Medicaid programs, and Managed Care Organizations (MCOs). Skilled in supporting individuals with disabilities and vulnerable populations managing chronic or complex health conditions. Demonstrated expertise in providing care coordination for children, young adults, and other high-need groups within the past three of the last five years.
• Must haves: good attendance, call center background; worked with MCO insurance
• Nice to haves: background in Service Coordination, and call center experience.
• Disqualifiers: no call center experience
• Software Skills: Will be using various software on the job: Microsoft Office Suite, Avaya, Zoom, Skype
• Top 3 must-have hard skills stack-ranked by importance: 1. Customer service, call center experience 2. Computer Knowledge 3. Insurance, MCO background.