Clinical Care Navigator

At ClareMedica, exceptional is the standard.

Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.

That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At ClareMedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.

Opportunity awaits – welcome to ClareMedica.

ESSENTIAL FUNCTIONS

The Clinical Care Navigator is a highly visible role in the organization and is responsible for ensuring optimal continuity of care for patients transitioning into and out of services. This individual proactively engages patients identified across risk categories and high utilizers of emergency room (ER) and inpatient (IP) utilization. The Clinical Care Navigator will be responsible for implementing targeted interventions to address medical and social needs and increase access to care. This individual will provide guidance and oversight of care coordination efforts to other members of the team (care coordinators), and handle clinical escalations as indicated. This role requires an understanding of how socio-economic stressors can impact the ability to engage in healthcare and subsequent health outcomes.

DUTIES AND RESPONSIBILITIES

• Develop care plans leveraging best practice framework as directed by CHP clinical protocols.
• Develop a holistic view of patient needs related to Social Determinants of Health.
• Identify existing barriers to patient engagement with the necessary center resources and support required.
• Provide education about the maintenance of chronic health conditions, as well as available options for behavioral care and social support.
• Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems.
• Initiate care planning and subsequent action steps for high-risk members, coordinating with the care team.
• Supporting patients’ self-determination, and motivating patients to meet the health goals they have identified.
• Refer patient to necessary services and support.
• This field may include but is not limited to assistance with transportation scheduling, food insecurity, navigation of benefits including, working to reduce costs associated with prescription medications, organizing schedules of follow-up appointments, and alleviating social isolation.
• Lead Care Management Team Meetings when indicated.
• Participate in clinical programming process improvement activities.
• Assess the patient’s family system, and conduct family meetings with the patient and family when needed.
• Participate in the creation and facilitation of team training content.
• Participate in and lead an interdisciplinary review of and coordination around complex patients.
• Maintain patient confidentiality in accordance with HIPAA.
• Document patient encounters in the medical record system in a timely manner
• Follow general policies related to fire safety, infection control, and attendance.
• Perform all other duties and responsibilities as required.
• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position does not have supervisory responsibilities.

QUALIFICATIONS/REQUIREMENTS

• Active Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), or Certified Medical Assistant (MA) is required.
• Bilingual in English/Spanish with the ability to speak, read, and write in both languages without limitations and assistance-- Must read, write, and speak fluent English.
• At least 2 years’ experience in patient care, case management, and knowledge of MSO
• Able to communicate effectively with empathy over the phone and while interacting with others.
• Current CPR certification or ability to obtain within 60 days of start date.
• Good time management skills.
• Ability to learn and master information related to locations and services of clients.
• Excellent analytical and problem-solving skills.
• Excellent verbal and interpersonal skills.

WORKING CONDITIONS

• General office working conditions.
• Hybrid/Remote Role, Corporate (Miami Lakes is the main office but there will be travel to Centers for patient support)

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

While performing the duties of this job, the employee will be required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust to focus. Frequent travel is required, often up to several hours of driving per day. Ability to travel to, attend, and conduct sales presentations. Manual dexterity is required to use desktop computers and peripherals. Exposure to variable weather conditions is likely.

WORK ENVIRONMENT

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

The noise level in the work environment is usually moderate.

TRAVEL

Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.

SAFETY HAZARD OF THE JOB

Minimal Hazards

This job description does not list all duties and responsibilities of the job. You may be asked by supervisors or managers to perform other instruction, duties and responsibilities, as appropriate. You will be evaluated in part based upon your performance of the duties and responsibilities identified in this job description.

Management has the right to revise this job description at any time. The job description is not a contract for employment, and either you or the employer may terminate employment any time, with or without cause.