Job Description

Primary City/State:

Tucson, Arizona

Department Name:

Community Care Navigator (CCN)

Work Shift:

Day

Job Category:

General Operations

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

As a Community Care Navigator, you will be an important connection between patients' PCP Offices, Case Managers, and inpatient care. You will work at Banner University Medical Center in Tucson. You will call upon your ability to start conversations and build relationships quickly to introduce patients to the program and offer your help as a resource. You will utilize your experience in the healthcare field to seamlessly work with providers, nurses, and other healthcare and care management team members.

Your work shift will be Monday - Friday from 8:00 a.m.-5:00 p.m.

Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position provides a single point person to connect all Banner Plan Network (BPN) Members with Value-Based relationships to programs and services to maximize health care benefits of all payers. This position works within the community and populations served to develop a comprehensive understanding and listing of services available to assist members in bridging any gaps associated with the management or improvement of their health. Utilizes specialized knowledge, judgment, and communication skills to ensure the members get the indicated care when and where they need and want it. In-person patient outreach is a critical component to this position.

CORE FUNCTIONS

1. Works with the patient to coordinate services into or out of a care setting in order to obtain appropriate services and benefits in collaboration with providers and clinical staff. This includes facility referrals or tasking other departments, coordinating home health care, confirming arrangements, making physician or outpatient appointments. Confirms that referrals to specialists or appointments met the needs of the patient.
2. Assists with patient navigation through the healthcare system by connecting the member with information or services. Bridges gaps between the member and the clinical team including but not limited to the following, connection to services, identifying social needs, addressing health literacy, cultural and social-class barriers. Reinforces activities of daily living and bridges necessary services to promote client health.
3. As an integral part of the health care team, this position will participate in huddles, practice meetings, or hospital rounding to understand and adapt to the needs of the Primary Care team. This role is integral to understanding and adapting to the needs of the Primary Care team and patient as a liaison for case management services.
4. Educates internal members of the health care team on care management, managed care concepts, and community resources. Facilitates integration of concepts into daily practice. Works to bridge the gap between the Banner Plans and Network Division services and services available outside of Banner Case Management.
5. Acts as the designated BPN representative within the community. Establishes and promotes a collaborative relationship with community agencies, physicians, payers, and other members of the health care team. Understands the role of PBN in providing care management services to members.
6. Serves as a point of contact for inquiries and requests from community partners and community organizations. Creates and maintains an up-to-date external list of community contacts. Ensures the Health Plan websites have current and accurate information related to Outreach and Community Resources.
7. Identifies potential outreach opportunities to inform current and potential members of community benefits and services and/or assists in the connection of members to community services when referred to by the multidisciplinary team or member services.
8. Documents all interventions and patient related activities accurately and timely in the correct medical record. Utilizes EHR to provide outreach for patients in respective preventative care as well as support as part of the care team.

MINIMUM QUALIFICATIONS

Associates Degree or equivalent working knowledge in community relations, care management, or health care related field.

Skill level typically achieved through a minimum of two years experience in community relations, care management, or health care related field. Must have reliable transportaton, valid driver's license, proof of car insurance and clean driving record. Require good oral and written communication, as well as listening skills to effectively interact pleasantly and calmly. Must possess computer skills, including proficiency with Office Suite. Must be able to effectively prioritize and make sound decisons following established department policies, procedures and standards. Ability to multi-task in a fast-paced environment with frequent interruptions. Must posses the ability work cohesively in a team environment with multiple disciplines.

PREFERRED QUALIFICATIONS

Community Health Worker, Medical Assistant, or other certification preferred. One year experience with Medicaid, Commercial Insurance and/or Medicare preferred. Medical terminology and/or background preferred. Bilingual skills (English/Spanish) preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

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