Job Description
About the position Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic 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. Within the Population Health team, Clinical Care Navigator's work very closely with the Care Navigation team and are at the core of the Curative member-oriented health plan. Our Clinical Care Navigators serve as a central point of contact to handle our most clinically complex members and members that want assistance in achieving their health goals. Responsibilities • Serve as a Clinical Care Navigator, working to coordinate the patient's plan of care with caregivers and providers • Facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation • Collect and assess member information pertinent to a member's history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services • Link members with appropriate providers and resources throughout the continuum of health and care settings, ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable • Maintain direct communication with the member, care providers, and other service delivery professionals while ensuring client privacy and confidentiality • Coordinate with Care Navigators (non-licensed staff) on an ongoing basis to maximize educational outreach to members • Participate in supporting new Curative programs and their implementation • Attend clinical team meetings and/or conferences as appropriate and assigned • Consistently meet established performance metrics and contractual obligations • Review and abide by Curative policies and procedures • Perform other duties as assigned to support the team Requirements • Graduate of an accredited nursing program with current RN licensure in good standing • At least 2 years minimum experience working as a Case Manager in a health plan setting • Background in managed care - experience working with vulnerable populations who have acute, chronic, or complex psychosocial needs • Ability to be nimble and work in a fast paced and changing environment • Current knowledge of services provided across the continuum of care • Knowledge of discharge planning and transitions of care • Excellent verbal and written communication skills • Excellent computer skills (we use Google suite) • Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications • Bilingual - Fluent in Spanish and English (verbal and written communication) Nice-to-haves • Certified Case Manager (CCM), Certified Managed Care Nurse (CMCN) or other relevant certifications • Bachelor of Science in Nursing degree (BSN) • Preferred: experience working in a start-up environment Benefits • Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset • Stipend will be provided for internet access Apply tot his job