ABOUT US

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what’s right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

JOB SUMMARY

The Member Navigator works directly with members who have chronic health issues, gaps in care, or are difficult to engage. Guides these members through the health care system and overcomes non-clinical obstacles preventing their care. Works closely with teams across departments, provider offices, and community resources to ensure timely delivery of quality, accessible health care services.

QUALIFICATIONS

• EDUCATION - Associate’s or 2 years of work experience above the minimum qualification
• EXPERIENCE - 3 Years of Experience

• Reaches out to and engages members by phone and other methods. Establishes a trusting relationship with members. Works with members to assess barriers preventing them from receiving needed care and treatment. Serves as member advocate and facilitator in overcoming barriers to care. Creates connections between members, health care providers, community resources, and case management staff as needed.
• Conducts member screenings and refers to case management if clinical needs are identified.
• Maintains appropriate documentation of member contact, referrals and outcomes. Verifies and updates member demographic information.
• Performs quality assurance reviews and trend studies. Initiates process corrections and training requirements. Sets goals for improvements. Conducts regular assessments of the navigation program. Identifies weaknesses and works across health plan departments. Creates and deploys strategies to improve program quality.
• Builds partnerships with teams across departments, provider offices, and community resources. This fosters timely delivery of quality, accessible health care services.
• Continuously expands knowledge and understanding of health plan services and benefits, provider network, and community resources.
• Develops scripts, process flows, etc. for member outreach.