Care Navigator
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Care Navigator supporting Lucet’s behavioral and physical health solutions. Handling member calls, screenings, referrals, claims, authorizations, and crisis escalations remotely.
Responsibilities:
- Serve as the primary point of contact for members and providers handling inbound behavioral health inquiries
- Verify eligibility and benefits and provide education on services
- Assist with claims and authorizations and route calls accurately
- Maintain HIPAA compliance
- Conduct behavioral health screenings
- Schedule appointments and referrals and connect members to network services
- Escalate crisis situations and clinical concerns to appropriate staff and resources
- Provide empathetic customer service and resolve routine claims inquiries
- Explain denials and submissions and escalate complex issues when appropriate
- Collaborate across teams on process improvements and operational changes
- Identify risk indicators during member interactions
- Document interactions across multiple systems and manage required paperwork
- Facilitate demographic updates and authorization requests
- Achieve performance metrics and contractual and service-level requirements
- Foster teamwork and support member care outcomes
Requirements:
- High School Diploma
- Excellent written and verbal communication skills
- Organizational and time management skills
- Problem-solving skills
- Ability to create warmth, openness, and calmness through phone-based communication
- Ability to establish trust quickly and motivate members through an engaging motivational approach
- Flexibility in managing conversations around varied member needs and concerns
- Strong computer skills, including MS Office Suite, Adobe Acrobat, and data processing
- Proficiency with data entry across multiple systems while talking and typing simultaneously
- Ability to pass background checks upon hire and throughout employment, including criminal, employment, education, sanctions, prohibited-party, sex-offender-registry, and 10-panel drug-screen checks
- High-speed internet service with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds
- Ability to work from a fixed, designated home workspace meeting company requirements
- Ability to use a dual-monitor desktop setup and hardwired internet connection
- Ability to adhere to a stationary workstation requirement
Benefits:
- Quarterly performance-based, discretionary incentive
- Medical, dental, and vision coverage
- 401(k) with competitive employer match
- Company-paid life and disability insurance
- Paid parental leave and wellbeing incentives
- Generous paid time off, including volunteer time
- Flexible spending accounts for healthcare and dependent care
- Professional development opportunities and tuition reimbursement
- Remote work flexibility
- Company-provided equipment
- Opportunity for meaningful personal and professional growth
Similar Jobs
Care Navigator
Care Navigator supporting Curana Health’s senior-care providers and patients remotely. Managing EHRs, scheduling, patient communications, records, and provider coordination.
Care Navigator
Remote Care Navigator coordinating clinical communication, EHR workflows, referrals, and patient follow-up. Supporting PeopleOne Health’s value-based primary care and member experience.
Care Navigator
Care Navigator guiding older adults and caregivers through Sailor Health’s mental health intake process. Coordinating therapist matching and providing compassionate patient support remotely across Canada.
Care Navigator
Care Navigator guiding Canadian older adults and caregivers through Sailor Health’s mental-health intake process. Matching patients with therapists and providing compassionate care coordination remotely.
Care Navigator
Remote Care Navigator coordinating patient outreach, appointment scheduling, and referral closure for TEKsystems healthcare clients. Documenting compliant records and supporting high-quality patient outcomes.
Member Care Navigator
Member Care Navigator helping members schedule care, resolve provider barriers, and understand benefits. Supporting affordable healthcare access for The OccuNet Company’s cost-containment operations.
Care Navigator
Care Navigator at Sailor Health guiding older adults through the intake process for mental health care. Providing emotional support and care coordination to enhance mental wellness.
LPN, Care Navigator
Remote LPN responsible for patient consultations and education in chronic disease management. Supporting patients in managing health conditions and improving outcomes through virtual care.
No more related jobs available.