Care Management Navigator I at VNS Health

New York, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

12 Feb, 26

Salary

26.23

Posted On

14 Nov, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Care Coordination, Communication, Problem Solving, Data Analysis, Documentation, Interpersonal Skills, Confidentiality, Healthcare Knowledge, Member Support, Report Auditing, Team Collaboration, Service Monitoring, Issue Resolution, Benefit Navigation, Administrative Support

Industry

Hospitals and Health Care

Description

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. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched 401k retirement saving program Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement and CEU credits What You Will Do 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 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 andAssociate's Degree in a healthcare related field preferred Work Experience: Minimum of one year of customer service experience requiredLanguage 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.

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Responsibilities

The Care Management Navigator I provides support to Care Coordinators and staff in resolving member-related issues and communicates with members about MLTC services. They also assist in monitoring member satisfaction and maintain expertise in VNS Health Plans MLTC benefits.