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Healthcare Navigator

1 week ago

City of Casey, Australia ArchWell Health Full time

About the Role:

We are seeking a highly skilled Care Coordination Specialist to join our team at ArchWell Health. As a Care Coordination Specialist, you will play a vital role in supporting our members as they navigate the complex healthcare delivery system.

Your Responsibilities:

  • Partner with our multi-disciplinary care team to gain a deep understanding of each member's care needs.
  • Coordinate referrals to external providers, vendors, and services to ensure care needs are met.
  • Complete proper documentation for member referrals to ensure records are accurate and current.
  • Build and nurture relationships with members and their families to successfully facilitate care coordination.
  • Carry out all activities and provide ongoing monitoring as outlined in a member's care plan to ensure routine follow-up and progression on care plan goals.
  • Promote clear communication among care team and treating clinicians to ensure positive member outcomes.
  • Assist members in problem-solving potential issues related to the healthcare system, financial or social barriers.

Required Skills and Qualifications:

  • Deep understanding of the healthcare ecosystem, ideally with experience in benefits and insurance authorization.
  • Passion for helping senior members successfully carry out care plans.
  • Ability to work effectively with diverse populations including staff, providers, members, family members, insurance carriers, vendors, and the public.
  • Basic medical terminology.
  • Understanding of Medicare criteria for equipment and supplies.
  • Knowledge of CPT and ICD-10 codes.