What are the responsibilities and job description for the Care Management Navigator (Bilingual Chinese Speaking) position at VNS Health?
Overview
Provides support to the Care Coordinators and other staff in the resolution of member related issues. Communicates with members and their families regarding information about MLTC services. Provides summary reports, analysis and support for care coordination related activities. Participates in non-clinical customer service for members enrolled in the VNS Health Plans MLTC plan in collaboration with Care Coordination department and other healthcare professionals. Works under general supervision.
* Works with members, providers, and staff to identify and resolve member service and retention related issues. Educates potential members/community representatives on plan features, plan benefits, and program admission requirements. * Coordinates telephonic intake and responses to both clinical and non-clinical customer service issues. Identifies nature of issue, independently responds to and resolves non-clinical issues and complaints, and escalates clinical issues to appropriate department and staff. * Assists in monitoring member satisfaction through phone calls to verify service, answering questions and providing information. Documents member service issues, identifies trends and recommends potential solutions. * Maintains expertise in VNS Health Plans MLTC benefits, network and organization structure. Acts as a resource to members to guide them in accessing their benefits. * Places orders or referrals for services and follows up to ensure services are scheduled and provided. Processes and monitors invoices for payment. * Serves as a resource for MLTC Care Coordinators and other staff in the resolution of member-related issues. * Establishes effective customer-focused working relationships with members, physicians and providers of long-term care services. * Audits system-generated reports, reconciles data, and distributes reports to management for review. * Participates in interdisciplinary team meetings and provides input on customer service related activities. * Protects the confidentiality of member information and adheres to company policies regarding confidentiality. * Ensures compliance with the VNS Health Plans OICE policies and procedures as well as all Federal and State regulations. * Provides administrative support to care coordination staff * Language Interpreter Only: Acts as a conduit between the care management team and members for communication in the member's preferred language with a high degree of accuracy Precept new interpreter staff Translation of written documentation and phone messages Coordinates interpretation assignment with the care management team as needed * Participates in special projects and performs other duties as assigned.
Qualifications
Licenses and Certifications:
Valid driver's license or NYS Non-Driver photo ID card, may be required as determined by operational/regional needs. required
Education:
High School Diploma or equivalent required and Associate's Degree in a healthcare related field preferred
Work Experience:
Minimum of one year of customer service experience required Language Interpreter Only: Ability to read, write, and speak the English language and their native or target language
Pay Range
USD $20.98 - USD $26.23 /Hr.
About Us
VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 "neighbors" who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
VNSNY is an equal opportunity employer M/F/D/V https://tbcdn.talentbrew.com/company/1238/v1_0/img/eeopost.original.pdf
Provides support to the Care Coordinators and other staff in the resolution of member related issues. Communicates with members and their families regarding information about MLTC services. Provides summary reports, analysis and support for care coordination related activities. Participates in non-clinical customer service for members enrolled in the VNS Health Plans MLTC plan in collaboration with Care Coordination department and other healthcare professionals. Works under general supervision.
* Works with members, providers, and staff to identify and resolve member service and retention related issues. Educates potential members/community representatives on plan features, plan benefits, and program admission requirements. * Coordinates telephonic intake and responses to both clinical and non-clinical customer service issues. Identifies nature of issue, independently responds to and resolves non-clinical issues and complaints, and escalates clinical issues to appropriate department and staff. * Assists in monitoring member satisfaction through phone calls to verify service, answering questions and providing information. Documents member service issues, identifies trends and recommends potential solutions. * Maintains expertise in VNS Health Plans MLTC benefits, network and organization structure. Acts as a resource to members to guide them in accessing their benefits. * Places orders or referrals for services and follows up to ensure services are scheduled and provided. Processes and monitors invoices for payment. * Serves as a resource for MLTC Care Coordinators and other staff in the resolution of member-related issues. * Establishes effective customer-focused working relationships with members, physicians and providers of long-term care services. * Audits system-generated reports, reconciles data, and distributes reports to management for review. * Participates in interdisciplinary team meetings and provides input on customer service related activities. * Protects the confidentiality of member information and adheres to company policies regarding confidentiality. * Ensures compliance with the VNS Health Plans OICE policies and procedures as well as all Federal and State regulations. * Provides administrative support to care coordination staff * Language Interpreter Only: Acts as a conduit between the care management team and members for communication in the member's preferred language with a high degree of accuracy Precept new interpreter staff Translation of written documentation and phone messages Coordinates interpretation assignment with the care management team as needed * Participates in special projects and performs other duties as assigned.
Qualifications
Licenses and Certifications:
Valid driver's license or NYS Non-Driver photo ID card, may be required as determined by operational/regional needs. required
Education:
High School Diploma or equivalent required and Associate's Degree in a healthcare related field preferred
Work Experience:
Minimum of one year of customer service experience required Language Interpreter Only: Ability to read, write, and speak the English language and their native or target language
Pay Range
USD $20.98 - USD $26.23 /Hr.
About Us
VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 "neighbors" who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
VNSNY is an equal opportunity employer M/F/D/V https://tbcdn.talentbrew.com/company/1238/v1_0/img/eeopost.original.pdf