Become a part of our caring community and help us put health firstThe RoleWorking within an interdisciplinary care team, the Care Navigator is responsible for proactively engaging patients identified as high-risk and implementing targeted interventions to address social needs and increase access to care. The Care Navigator will provide guidance and oversight of care coordination efforts to other members of the team, and handle clinical escalations as indicated.This role requires an understanding of how socio-economic stressors can impact ability to engage in healthcare and subsequent health outcomes. Experience will ideally include prior work with patients with behavioral health diagnoses, as well as in navigating local community-based resources and benefit applications.This role has a mobile presence, involving travel to patients' homes, treatment facilities and community-based settings, and assigned clinics to facilitate and foster connections.Major Duties and Responsibilities
Conduct Transitions of Care Management for a subset of the patient population, including ER and hospital follow ups
Provide triage guidance and supportive consultation to other team members, handling escalated complex cases
Develop care plans leveraging 5Ms Geriatric best practice framework
Develop a wholistic view of patient needs related to Social Determinants of Health
Identify existing barriers to engagement with necessary resources and supports
Provide education around maintenance of chronic health conditions, as well as available options for behavioral care and social support
Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems
Initiate care planning and subsequent action steps for high-risk members, coordinating with interdisciplinary team
Supporting patients' self-determination, motivate patients to meet the health goals they have identified
Refer patient to necessary services and supports
Lead Interdisciplinary Team Meetings when indicated
Assess patient's family system, and conduct family meetings with patient and family when needed
Participate in creation and facilitation of team training content
Conduct group psychoeducation and support groups within the Center
Perform all other duties and responsibilities as required
Participate in and lead interdisciplinary review of and coordination around complex patients
Maintain patient confidentiality in accordance with HIPAA
Document patient encounters in medical record system in a timely manner
Follow general policies related to fire safety, infection control and attendance
Use your skills to make an impactRequired Qualifications
Registered Nurse (RN license)
Minimum of 4 years of experience working in human services and navigating community-based resources
Preferred Qualifications
Familiarity with state Medicaid guidelines and application processes preferred
Experience working with patients with behavioral health conditions and substance use disorders preferred
Prior experience conducting home visits and knowledge of field safety practices preferred
Skills/Abilities/Competencies Required
Advanced clinical acumen
Ability to multi-task in a fast-paced work environment
Flexibility to fluidly transition and adjust in an evolving role
Excellent organizational skills
Advanced oral and written communication skills
Strong interpersonal and relationship building skills
Compassion and desire to advocate for patient needs
Critical thinking and problem-solving capabilities
Working ConditionsThis role has a mobile presence, involving travel to patients' homes, treatment facilities and community-based settings, and assigned clinics to facilitate connections.BenefitsHealth benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsWorkstyle: Combination in clinic and field, local travel to meet with patientsLocation: Must reside within the Boynton Beach metro areaHours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs.Scheduled Weekly Hours40About usAbout Conviva: Conviva Care Centers provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana's Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.Equal Opportunity EmployerIt is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. https://www.eeoc.gov/sites/default/files/migratedfiles/employers/eeocselfprintposter.pdfIf you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact [email protected] for assistance.