Kaiser Permanente Medicaid & Charitable Care Navigator in Oregon, Oregon
The Special Populations Member Navigator aids newly enrolled individuals and their families to successfully access health care services within Kaiser Permanente and to identify and assist members to access non-KP benefits and community services.
Essential Functions: - Orientation: Provides orientation to the KP integrated care system and PCP model for all new Special Populations (Special Pops) members. Orientation includes but is not limited to; available KP and external resources such as the KP Nurse Advice Line, Exceptional Needs Program, dental care, transportation and translator services. Verifies that members have received their ID card and orders cards as needed. Educates member to the role of the PCP and the appropriate use of health care resources. - Screening: Through the use of a telephonic screening process, identifies members that have unmet needs or active concerns. This may include ethnic and language considerations to care, social issues, chronic disease including mental health, disabilities or current pregnancy. - Intervention: Assist member with finding and accessing needed services and medical care, including but not limited to making PCP selection, scheduling appointments, assisting with RX refills, transportation arrangements, and assistance for making contact with outside resources or benefits; i.e. mental health and dental providers. - Follow-up: Refers cases to the Exceptional Needs Program for assistance and guidance when complex issues or concerns are identified. As directed by RN, makes other arrangements and referrals and communicates findings and actions to the PCP or other providers. Through population review, re-contacts previous outreach members to follow-up on overuse of ED and missed appointments; reinforcing appropriate use of resources. Assists with needed arrangements to support appropriateness. - Documentation and Communication: Provides general administrative support to the Medicaid program through recordkeeping, scheduling meetings and filing as requested.
Qualifications: Basic Qualifications: Experience - Minimum two (2) years of experience with health related customer service, medical office practice or other patient-related experience in the ambulatory setting. Education - High school diploma or General Education Development (GED) required. - Minimum one (1) year of college or technical training. License, Certification, Registration - N/A
Additional Requirements: - Medical terminology.
Preferred Qualifications: - Minimum three (3) years of experience in health related customer service, medical office practice or other patient-related experience in the ambulatory setting. - Experience with outreach programs. - Associate's degree in business administration, communication, marketing, or health related field. - Excellent oral and written communication skills and demonstrated ability to establish rapport with patients/members. - Ability to manage multiple work priorities and requests from members. - Demonstrated ability to effectively use Microsoft Word and Excel and the ability to quickly learn new computerized systems such as appointing programs. - Must demonstrate initiative and excellent problem solving skills.
COMPANY Kaiser Permanente
TITLE Medicaid & Charitable Care Navigator
LOCATION Oregon, OR