Curative wants to change the view on what a health plan can be. We created a health plan reinvented for a 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. As a part of Curative’s Population Health team, we are seeking an experienced and dynamic Care Navigator who will be assigned member accounts and they are responsible for helping our members navigate healthcare, engage in preventive care, and partner with them towards achieving their health goals
Essential Functions
Primarily responsible for conducting, facilitating, and leading a member’s initial or renewal Baseline Visit via Zoom virtual meeting
Develops relationships with members and educates/assists in the completion of their baseline visit.
Listens to/educates/assists members towards their healthcare goals - provides motivation, coaching, facilitating, and education for members
Helps members review benefit concerns and connects them with the appropriate internal resources to expedite resolution of concerns and inquiries. Discusses and answers benefit and appeals related questions
Performs other duties and responsibilities as assigned
Supports special programs within the department
Coordinates and completes correspondence according to established workflows
Ensure assigned members have a great experience seeking and receiving care
Support Curative operations by assisting with care coordination, prior authorizations, claims issues, pharmacy issues and resolution, etc
Improve the member experience by anticipating care interventions before serious issues arise
Be knowledgeable about our technology products, clinical programs, and policies and be able to communicate them effective
Provide feedback and input towards process improvements within the department
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
2+ years of experience in a medical office role/health plan/care navigation/case management
At least 1 year of experience working in a clinical setting
Exceptional written and verbal communication
Analytical mindset
Strong ability to use and learn new technology tools
Strong interpersonal skills
Exceptional attention to detail and organizational skills
Willingness to continually self-educate
Capable of working independently with minimal supervision and also as part of a team
Required Education And Experience
Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
Bachelor's degree (B. A.) from four-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience.
Preferred Education and Experience:
Experience working in a health plan, healthcare provider, hospitality, or custom service
Understanding of medical terminology
Work Environment
This job operates in a remote environment with the need to have a reliable internet and phone connection
Must have a quiet place, secure, with no distractions to perform duties for work from home
Must have password protected, stable internet access - stipend will be provided
Work location MUST be secure and private to maintain HIPAA compliance for work from home
Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Position Type/Expected Hours of Work You’ll take on challenging work, but you can be located anywhere in the continental U.S. This is a full-time hourly position.There are multiple shifts available: Working hours between 7 a.m. CST through 9 p.m. CSTDays are:
■ Monday through Friday
■ Tuesday through Saturday
■ Sunday through Thursday
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