About the position
Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. $0 copays and $0 deductibles when members complete the Baseline Visit within 120 days of enrollment into the Plan. The Population Health Team is responsible for driving improved health outcomes, leveraging a data-first mindset to help our members achieve their optimal health well-being. Within the Population Health team, Clinical Care Navigator's work very closely with the Care Navigation team and are at the core of the Curative member-oriented health plan. Our Clinical Care Navigators serve as a central point of contact to handle our most clinically complex members and members that want assistance in achieving their health goals.
Responsibilities
• Serve as a Clinical Care Navigator, working to coordinate the patient's plan of care with caregivers and providers
• Facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation
• Collect and assess member information pertinent to a member's history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services
• Link members with appropriate providers and resources throughout the continuum of health and care settings, ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable
• Maintain direct communication with the member, care providers, and other service delivery professionals while ensuring client privacy and confidentiality
• Coordinate with Care Navigators (non-licensed staff) on an ongoing basis to maximize educational outreach to members
• Participate in supporting new Curative programs and their implementation
• Attend clinical team meetings and/or conferences as appropriate and assigned
• Consistently meet established performance metrics and contractual obligations
• Review and abide by Curative policies and procedures
• Perform other duties as assigned to support the team
Requirements
• Graduate of an accredited nursing program with current RN licensure in good standing
• At least 2 years minimum experience working as a Case Manager in a health plan setting
• Background in managed care - experience working with vulnerable populations who have acute, chronic, or complex psychosocial needs
• Ability to be nimble and work in a fast paced and changing environment
• Current knowledge of services provided across the continuum of care
• Knowledge of discharge planning and transitions of care
• Excellent verbal and written communication skills
• Excellent computer skills (we use Google suite)
• Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications
• Bilingual - Fluent in Spanish and English (verbal and written communication)
Nice-to-haves
• Certified Case Manager (CCM), Certified Managed Care Nurse (CMCN) or other relevant certifications
• Bachelor of Science in Nursing degree (BSN)
• Preferred: experience working in a start-up environment
Benefits
• Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
• Stipend will be provided for internet access
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