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As a Health Plan Care Management Navigator, you will provide critical care management support to the Care Management team responsible for navigation assistance for our members/caregivers and providers, in accordance with Medicare and Medicaid regulatory compliance standards.
Full time, Day shift: 8:00AM-5:00PM
Banner Health Plans - Elvira, Tucson
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About Banner University Health Plans
Banner University Health Plans (BUHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.
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Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
Provides critical care management support to the Care Management team, which provides multifaceted healthcare navigation assistance to members/caregivers and providers in accordance with regulatory compliance standards. The position performs a variety of functions that support the RN Care Managers to meet regulatory requirements and the needs of Health Plan members. This position will be supporting an interdisciplinary case management team experiencing growth related to new contractual commitments. Supports the model of care and serves as part of the integrated care team that manages the members wellbeing. Performs telephonic outreach to our new health plan members to obtain a health risk assessment, as well as to welcome the members onto the health plan and ensure that the nurse care managers have the information needed to put together a care plan for the members. Serves as support staff for the nurse care managers and assist in sending out letters, mailings, and other administrative tasks as needed. Works with other team members to perform outreach based on condition management needs via the Warm Health Dashboard - an interactive program that allows our members to contact us when they would like to speak to a care manager. Enters health risk assessments and health history questionnaires into our medical record system, as well as tasking the nurse appropriately. Responsible for the monthly update of the health risk assessment for University Care Advantage members via telephonic outreach and works with other team members to complete this outreach and assist members with other miscellaneous tasks, as well as promote active care management to our members.
Provides advanced administrative or business support for one or more departments. Demonstrates excellence in organization, communication and human relations skills. Demonstrates strong understanding of area practices and procedures. Shows ability to organize, prioritize and mutli-task workload in fast-paced environment.
Uses established policies and general instructions and procedures to resolve a variety of problems. Chooses the best alternative from group of known possibilities.
Ensures accessibility of accurate information to department personnel as needed. Performs data entry into software applications systems for department. Responds to standard requests from internal and/or external customers. Interacts primarily with department personnel, cross- department personnel, supervisor and external customers.
Works cohesively with team members to ensure delivery of outstanding customer service, in a positive work environment, that supports the departments ongoing goals and objectives. Prioritizes and organizes own work. Uses discretion to modify work practices to achieve results or improve efficiency.
High school diploma/GED or equivalent working knowledge.
Must demonstrate effective communication and customer service skills, human relation skills and time management skills with flexibility in responding to multiple demands. Moderate experience, typically gained through 1-2 years relevant work experience
Must have computer skills, proficient in Microsoft office suite and able to multitask.
1-2 yrs experience, C.N.A. or M.A. preferred. Bilingual English/Spanish strongly preferred.
Additional related education and/or experience preferred.