3 days old

Care Navigator WellMed Healthcare San Antonio TX

San Antonio, TX 78205
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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work. (sm)

The primary responsibility of the Care Navigator is to identify, track, monitor, and coordinate the care of members enrolled in Specialized Clinical Programs. As a Care Navigator, you will act as a resource and advocate for members and their families to ensure an optimal level of health. This position is responsible for communication to members, physicians and other care management team serving as a liaison with external departments to ensure optimal customer service.   


Primary Responsibilities
  • Establishes a trusting relationship with identified members, caregivers, clinic staff  and physicians.
  • Keeps member actively engaged with their primary care physician and assists member with any scheduling medical appointments/transportation
  • Partners with the members care team (community, providers, internal staff)
  • Serves as primary point of contact for internal and external stakeholders
  • Provides guidance and inquires if members need help with any specific barriers to healthcare through telephonic outreach to assist member's compliance  with their care plans
  • Identifies health plan resources or local community resources to provide solutions for the member
  • Engages patient, family, and caregivers to assure that a well-coordinated treatment plan is established
  • Creates referrals to outside source(s) to assist with member's  self-management goals
  • Supports the member to ensure pick-up and adherence of their medications
  • Proactively engages the member to manage their care
  • Liaisons with providers and facilities telephonically, to assist in problem solving regarding member needs
  • Communications with internal staff, member/caregiver and community providers must be accurate and timely
  • Member outreach using compassionate customer service with the goal to inform them of care gaps and facilitate  the closing of those gaps
  • Documents all member interactions in a concise manner that is compliant with documentation requirements for Model of Care and Center for Medicare and Medicaid Services (CMS) regulations
  • Conducts in-bound and out-bound calls including, but not limited to: patient scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members
  • Provides clerical and/or administrative support to clinical staff and managers
  • Enters timely and accurate data into the electronic medical record to communicate member needs and ensure complete documentation of member visits and phone calls
  • Performs all duties for internal and external customers in a professional and responsible manner
  • Adheres to organizational and departmental policies and procedures
  • Performs all other related duties as assigned 
This is a fast call center environment located at our office off of Northwest Parkway, 78249 in San Antonio, TX.  This position requires answering calls, data entry and working with nurses 1on1 to provide end to end care. This position requires working weekly various shift hours including evenings and rotating/required weekends.


You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Posted: 2020-05-23 Expires: 2020-06-22

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Care Navigator WellMed Healthcare San Antonio TX

UnitedHealth Group
San Antonio, TX 78205

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