Job Description: The Risk Adjustment Care Navigator engages Health Plan members and schedules Risk Adjustment appointments

ROLE AND RESPONSIBILITIES

• Engages Health Plan member and employs professional techniques during verbal communications, electronic correspondence, and text-based interactions with each member.

• Assists Health Plan Members with scheduling appointments with the Nurse Practitioners (NP’s).

• Update and maintain accurate documentation of each member encounter in the electronic health record (EHR).

• Accurate documentation of appointments.

• Proper execution of member referral/concerns/grievances when applicable.

• Document timely member observations requiring administrative notification of any critical member issues/concerns.

• Follows all Policies and Procedures of SCCP.

• Compliant with Performance Goals / Contract Deliverables.

• Participates in all SCCP mandatory and CMS regulatory training.

• Attends all staff meetings – in person or telephonic (if unable to attend, responsible for knowledge of content). • Abide by principles and laws related to confidentiality. • Demonstrate respect for individual diversity (culture, ethnicity, gender, race, religion, age, economic status). • Interact with staff and members to optimize workflow efficiency. • Other duties as assigned by Direct Report.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

• High School Diploma or Equivalent Required.

• Minimum of 1 year of Call Center Representative Experience Preferred.

• Minimum of 2 years in a Customer Service Role Required.

PREFERRED SKILLS

• Excellent verbal communication skills.

• Ability to interact with health care professionals in a professional manner. • Computer Literate – Word, Google Doc and Excel.

• Able to multi-task, manage time and set priorities.

• Able to remain coachable and teachable at all times.

• Bilingual Preferred