LPN Health Navigator – Behavioral Health

🔥 0 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $25 - $47 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Capital Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1938

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

📋 Description

• Identify, facilitate, and secure access to healthcare, social service benefits, and community resources • Help members navigate the steps toward efficient and effective care • Coordinate appointments and transportation to physicians and non-physician providers • Monitor incoming calls, conduct outgoing calls, and respond to voicemail requests • Identify and assess members’ medical, behavioral, social, emotional, and financial needs • Connect at-risk members with appropriate community resources and conduct health education • Build relationships with members, families, and caregivers and support healthcare goals • Provide emotional support and refer members for higher-level psychosocial intervention when needed • Educate assigned members and engage them in programs • Complete interventions, surveys, and assessments supporting health, wellness, and care-program engagement • Deliver condition-specific education, medication-adherence guidance, preventive-care guidance, and health-benefit navigation • Address gaps in care, reinforce provider care plans, and promote evidence-based practices • Collaborate with interdisciplinary teams to support whole-person care and improve quality outcomes • Identify and report quality-of-care issues • Maintain member confidentiality • Document care-navigation activities in the care-management documentation system • Attend company and departmental meetings and training sessions • Retrieve and assign referrals and complete monthly reconciliation reports

🎯 Requirements

• At least three (3) years’ recent/related experience working in health and wellness promotion, inpatient or other appropriate clinical setting • Behavioral Health experience preferred • Patient Navigation certification preferred or obtained within 1-year employment • Licensed Practical Nurse active license or degree in healthcare related field and 3 years of experience directly related to the duties and responsibilities specified • Knowledge of medical, behavioral, and social systems • Knowledge of NCQA standards for Population Health Management, DMAA standards for disease management, CMSA Standards of Practice for Case Management, Act 68, and CMS • Knowledge of current and emerging medical treatment modalities and best practice guidelines • Knowledge of adult learning principles, motivational interviewing, and intrinsic coaching techniques • Critical thinking and problem-solving skills • Excellent written, oral communication, listening, and organizational skills • Proficiency in Microsoft Office Products • Ability to use a computer system while conversing telephonically • Strong customer service skills • Ability to prioritize workload and complete duties accurately and on time • Ability to work autonomously and as part of an interdisciplinary team • Sound judgment concerning the rights and responsibilities of members, families, healthcare professionals, and healthcare organizations

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • Flexible work environment • Training and continuing education • Opportunities to volunteer in the community