Insurance Navigator/Ongoing Care Coordinator

The primary purpose of this dual position is: to provide ongoing Care Coordination and Insurance Navigator. This would aid in linking the general public and service agencies to clinical services at ElevaCare; and to utilize all available data, technology and personal skills in order to coordinate the behavioral and physical health-care needs of individuals, families and children throughout their treatment experience at ElevaCare.  This position will assist clients with finding and accessing appropriate healthcare services, resources, and insurance options.

This dual position will monitor the treatment process including:  intake; insurance options, necessary referrals; educating; and treatment plan reviews in order that clients have a full understanding of their current and recommended services, allowing for highest levels of involvement in their treatment. This position will work closely with all internal and external service providers to assist in establishing care coordination provided for all health needs of our clients.  This dual position will use his or her skills; motivational and client-centered skills; problem-solving skills; and a thorough knowledge of ElevaCare, community services, and resources to assist clients in achieving quality health care; health goals; and highest possible quality of life. 

EDUCATION, EXPERIENCE AND SKILLS REQUIRED

• Two-year technical college diploma or equivalent education and experience preferred.
• Experience or ability to use office equipment and technology.
• Strong verbal, written, organizational, and interpersonal skills.

ESSENTIAL FUNCTIONS

• Follow established protocols for front desk duties including:

1. Triaging phone calls for scheduling of first-time appointments;
2. Secure needed background information; have ongoing contact with referral sources to ensure linkage to services.
3. Complete required admission forms and obtain signatures as needed;
4. Assist clients with finding and accessing appropriate healthcare services, resources, and insurance options
5. Inform clients of their rights and responsibilities and data privacy;
6. Obtain and update demographic information including insurance and billing;
7. Obtain necessary releases of information to external providers and agencies
8. Request and file all background information from outside organizations;
9. Assess clients risk level by using the CSSRS brief to determine routine (10 days), urgent, or if crisis services are needed.
10. Review ElevaCare client appointment attendance
11. Follow all scheduling procedures when scheduling internally for therapy, psychiatry, and substance use services.
12. Assist walk-ins at the agency in connecting to services at ElevaCare

• Follow ElevaCare policies and procedures for care coordination including:
  1. Provide supportive activities including in-person, phone calls, problem-solving, motivational counseling, patient advocacy, patient education, knowledge of resources, and outreach in order to help people reach their overall health-care goals.
  2. Managing a caseload of clients
  3. Coordinating and updating demographics including billing information, and insurance.
  4. Coordination of all services; internally and externally
  5. Monitoring  a case load of screening tools complete during their care and treatment, screening tools include:
     • PHQ-9, PHQ-9A
     • GAD-7
     • Columbia Suicide Severity Rating Scale (CSSRS)
     • Social Determinants of Health
     • Gain-SS (substance use and mental health screener)
     • Audit-C (substance use risk)
     • Fagerstrom Nicotine, Smokeless Tobacco, Electronic Cigarette Dependency.
     • Biosocial Gambling
• Monitoring and assisting a case load of clients in the completion of intake, and six month follow up screening tools to monitor clients overall health and treatment progress.

1. Effective communication between staff, clients, providers and family members when coordinating care.
2. Provide clients education about behavioral health conditions;
3. Attend and coordinate meetings with the clients care team and assist with treatment planning process;
4. Contribute to clients’ overall quality of care; and discharge/transfer planning for those clients choosing to discontinue ElevaCare service and or recently been admitted or discharged from a hospital, inpatient mental health or substance use treatment facility.

• Provide services according to the mission and values of ElevaCare.
• Provide services that are sensitive to the age, gender, language, sexual orientation, ethnicity and cultural backgrounds of our clients.
• Collect, maintain and utilize available data to meet identified goals and determine most appropriate and best, client-centered motivational techniques and strategies.
• Maintain appropriate boundaries and set positive examples for clients and others.
• Ensure clinical records are in compliance with ElevaCare record criteria, standards and expectations.
• Maintain client confidentiality in accordance with all ElevaCare, State and Federal guidelines.
• Appropriate communication is maintained with your supervisor regarding your assigned caseload.
• Attends conferences and workshops, at Center expense, as directed.
• As needed, maintain contact with outside stakeholders in order to gain feedback regarding program services.
• Monitor hospital and ER admissions and discharges through Point Click Care to ensure follow-up services with the consumer within twenty-four (24) hours of discharge for all clients of ElevaCare and or referrals. Is available for support and assistance with emergency situations.
• Attend weekly Care Coordinator Meetings and 1:1 meetings with Supervisor
• Other duties as assigned by your supervisor.

   OTHER RESPONSIBILITIES      

• Available for evening and weekend work as required by Center needs.                         
• Ability to travel as position requires.                                                                                    
• Performs other work-related duties as assigned.
• Is sensitive and responsive to management needs such as data collection and program evaluation.

COMPUTER SKILLS

•    Knowledge of Microsoft Office Suite.  Must be able to perform basis operations on a computer within the Windows operating system.
•    Knowledge of Electronic Health Records & Billing Services software programs. 
•    Basic knowledge of PC 's, laptops, printers, scanners, etc.

REQUIRED PHYSICAL ABILITIES

• While performing the duties of this job, the employee is regularly required to stand; use hands to finger, handle, or feel; and talk or hear.
• The employee frequently is required to travel to all ElevaCare facilities in the catchment area, ambulate within and between departments; reach with hands and arms; stoop, kneel, crouch, or crawl; and taste or smell. 
• The employee is occasionally required to sit and climb or balance. 
• The employee must occasionally lift and/or move up to 40 pounds.      
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

REQUIRED COMMUNICATION/MATHEMATICAL/REASONING SKILLS

• Must possess the required level of skills and abilities to read, write, speak, and apply mathematical concepts and sound reasoning to successfully perform the essential duties and responsibilities of this job.
• Must be able to perform basic operations on a computer within the Windows operating system.
• This position requires problem solving skills, critical thinking skills, and the ability to multi-task.

RESPONSIBILITIES, EXPECTATIONS & STANDARDS

• Commitment to the daily application of ElevaCare’s mission, to serve patients, their families and our community.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations and standards associated with all applicable governing bodies.

WORK ENVIRONMENT

• May be exposed to communicable diseases when working in a health care environment.
• The employee is occasionally exposed to wet and/or humid conditions and outside weather conditions. 
• The noise level in the work environment is usually moderate.

ESSENTIAL QUALIFICATIONS

The individual must be able to work the hours specified above. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed above are representative of the knowledge, skills, and/or abilities required to perform the essential functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions, so long as the accommodations do not cause undue hardship to the employer.

Salary : $27 - $30