Care Navigator (TX) - 165285

***MINIMUM 4 years of Managed Care & Medicaid experience REQUIRED for consideration***

***Experience working with children/youth REQUIRED***

Care Navigator – Remote (Texas)

Contract: 6-Month (potential to extend or convert)
Compensation: $20.00 – $23.00/hr
Location: Remote (must reside in Texas)
Shift: 9:30 AM – 6:00 PM CST
Schedule: Monday–Friday
Training: 8:00 AM – 5:00 PM CST
Overtime: Possible based on business needs (not guaranteed)

Position Overview

The Care Navigator supports families, members, and healthcare providers participating in the Texas Medicaid STAR Kids program. This is a remote inbound call center role focused on helping callers understand and utilize Long-Term Services & Supports (LTSS), Medicaid benefits, and service coordination processes.

This role is fully phone-based and requires strong customer service skills, critical thinking, and documentation accuracy.

Key Responsibilities

• Manage high-volume inbound calls from members, legally authorized representatives, and providers
• Educate callers on LTSS programs such as MDCP, PCS, DAHS, Respite, and DME requests
• Assist providers with LTSS authorization inquiries
• Document all calls accurately using complete sentences, proper grammar, and correct formatting
• Collaborate with service coordination teams, peers, and leadership
• Use multiple systems simultaneously (Microsoft Office Suite, Avaya, Teams, OneNote, Zoom, Skype)
• Maintain productivity expectations in a structured remote call center environment
• Uphold HIPAA, Medicaid, and compliance guidelines

Required Qualifications

Candidates must meet all of the following requirements to be considered:

• Minimum 4 years experience in call center, Medicaid, and Managed Care (MCO) environment
• Experience working with children or youth for at least 3 of the past 5 years (contractual requirement)
• Remote-ready environment with ability to wear headset for full shift
• Strong attendance history and reliability
• Excellent listening, customer service, documentation, and communication skills
• Ability to navigate multiple systems and respond in real time via Teams
• Knowledge of Medicaid and/or Medicare programs
• High School Diploma or GED

Disqualifier: No call center experience

Preferred (Not Required)

• Background in service coordination, long-term care, or case management
• Experience in Medicaid STAR Kids or STAR PLUS programs
• MCO insurance experience
• BA in Social Work, Healthcare Administration, or related field
• CNA, CMA, LVN, Pharmacy Tech, RT, or similar clinical credential

Skills & Competencies Sought

• Critical thinking and problem-solving
• Empathetic communication
• Crisis de-escalation and conflict resolution
• Cultural competency
• Compliance awareness (HIPAA, Medicaid, regulatory)
• Ability to self-learn and follow structured workflows
• Fast system navigation & multi-tasking

Work Environment & Technology

This role operates in a structured remote call center environment with daily collaboration via Teams. Candidates must have:

• Quiet workspace free from distractions
• Reliable internet connection
• Comfort working with multiple applications simultaneously
• Ability to adapt to changing member needs

Software used includes:
Microsoft Office Suite, OneNote, Teams, Avaya, Zoom, Skype

Career & Learning Exposure

This role provides experience in areas such as:

• Medicaid Managed Care
• LTSS (Long-Term Services & Supports)
• Service Coordination workflows
• Member advocacy and interdisciplinary care
• Case management processes
• Regulatory & compliance frameworks
• Cultural competency & communication

INDSV

Job Types: Full-time, Contract

Pay: $20.00 - $23.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Experience:

• Medicaid & Managed Care: 4 years (Required)
• Working with children: 3 years (Required)

Work Location: Remote

Salary : $20 - $23