Healthcare Navigator/ Targeted Case Manager

Position Summary:

The Healthcare Navigator/ Targeted Case Manager is responsible for assisting potential program participants obtain medical insurance coverage, obtaining and maintaining prior authorizations, identifying community resources, maintaining appropriate timely documentation, and maintaining the electronic health record(EHR) of clients served Essential Job Functions include those listed below.

Essential Job Functions:

• Helps enroll or reenroll eligible individuals into health insurance plans including Medicaid across multiple programs.
• Assists in obtaining and tracking prior authorization’s for services.
• Locates and connects clients with community assistance support services to help achieve their goals and meet basic needs.
• Documents each client encounter within the electronic medical record.
• Maintains adherence to the documentation timelines of WCKY and all associated oversight bodies or agencies.
• Maintain consistent contact with clients, as defined by agency and department of Medicaid services standards.
• Educates and refers potential program participants to applicable services both internal and external.
• Completes screenings and assessments of potential program participants.
• Travel between, WCKY program’s connecting with new and transitioning clients in order to connect them with services.
• Input data into the EMR including demographics, insurance information, authorization information, treatment plans, treatment plan reviews, case notes for each encounter, assessments, and follow up appointments.
• Produces reports for the Program Director and Operations Manager as needed;
• Provides feedback to the Program Director and the Operations Manager regarding attainment of goals and objective as well as data collection;
• Assists area and programmatic leadership in Performance Improvement activities;
• Assists other WestCare staff as needed to promote cooperation and portray a professional image to the community;
• Embraces and embodies the mission, vision, guiding principles, clinical vision and goals of WestCare Foundation;
• Performs any other duties as assigned.