Job Details

Description

HCBA PATIENT CARE NAVIGATOR

Center for Elders' Independence (CEI) provides a Home and Community-Based Alternatives (HCBA) Waiver Program that allows Medi-Cal beneficiaries with high-level care needs to continue to live at home or in the community by identifying and ensuring they receive services that will sustain their health and safety outside of an institution.

The Position: Reporting to the Director of HCBA, the Patient Care Navigator performs as Home and Community-Based Care Based Alternatives (HCBA) department generalist and first point of contact. Independently performs assigned duties. Interacts with all levels within and outside the organization to release or receive information and handles issues within scope of the role.

The salary range for the Patient Care Navigator role at Center for Elders Independence is $22.96 - $34.43 per hr. Salaries are based on the market for the Patient Care Navigator position, as well as experience, skills, abilities and work history.

Duties and Responsibilities:

• Acts as part of the PCN team that is the initial point of contact for all department calls.
• Interfaces with participants for data collection, scheduling, and care coordination needs.
• Initiates phone screens interview to gather general information prior to RN's facility/home assessment/reassessment visit.
• Explains the HCBA program's criteria for eligibility, enrollment, and waiver services.
• Partners with program director to increase HCBA Waiver awareness among community partners.
• Communicates with other county service providers to facilitate beneficiary care.
• Triages HCBA calls, voicemails, emails, and faxes appropriately.
• Performs monthly check-in calls with participants and escalates issues to RN Case Manager as needed.
• Responsible for processing waiver applications. Enters information in MedCompass. Tracks application status.
• Sends out Plan of Treatment (POT) for signatures, as well as other waiver forms and correspondence, including but not limited to, mailing out Notice of Action and Informing Notice letters as directed. Tracks documents progress to completion.
• Provides administrative support for HCBA Case Management Team (CMT) for care coordination functions including printing/faxing/scanning of participant documents.
• Assists with registration of WPCS (Waiver Personal Care Services) caregivers and troubleshoots time sheet issues.
• Receives information and assures delivery to correct recipient, maintain strict confidentiality in handling medical records.
• Receives and communicates medical/ clinical information and notifies case manager as needed.
• Listens to and documents participant concerns and facilitates satisfactory resolution. Escalate to program director as needed.
• Open to best practice model suggestions. Offers input and complies with department standards of care and practice as well as quality improvement activities.
• Makes process improvement suggestions.
• Performs other duties as assigned to support the HCBA team and/or director and assist with provision of care coordination services.

Qualifications:

• Bachelor's degree in social work, gerontology, marriage and family therapy, or psychology, highly preferred.
• Demonstrated excellent customer service and oral communication skills required.
• Health plan experience with member coordination/communication and clerical management experience required (usually 3-5 years) preferred.
• Experience working with electronic medical records and intermediate/advanced computer skills (Microsoft Office Suite) required.
• Ability to perform duties in heavy workload environment.

Center for Elders' Independence is a PACE (Program of All- Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities. Unlike other healthcare plans, CEI is not a "fee-for-service" plan. It is a "capitation" healthcare plan. CEI is paid a set amount for each person enrolled in our program, whether or not that individual seeks care. We are a growing company that offers stability and continues to thrive.