Care Navigator-Foster Care

Purpose: Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination. Key Details: This position is remote/work from home approximately 75% of the time and travels approximately 25% of the time in assigned Illinois counties: Champaign, Christian, Coles, Jersey, Logan, Macon, Macoupin, Morgan, Sangamon; applicants should reside in one of these counties as well. The work schedule is Monday - Friday 8am - 5pm central time zone and this position requires scheduling flexibility, including the ability to adjust work hours to support occasional evening and weekend responsibilities based on operational and stakeholder needs. Navigator will visit local DCFS/CWCA office twice a week in one or more of the following Illinois counties: Champaign, Christian, Coles, Jersey, Logan, Macon, Macoupin, Morgan, Sangamon. Child Welfare Employee License (CWEL) is strongly preferred. Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome Develops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators May perform on-site visits to assess member’s needs and collaborate with providers or resources, as appropriate May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits Other duties or responsibilities as assigned by people leader to meet the member and/or business needs Performs other duties as assigned. Complies with all policies and standards.

Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. For Illinois YouthCare Plan Foster Care Liaison Roles only: Will be stationed on-site and hosted by DCFS Regional Offices throughout the State to provide administrative coordination with DCFS staff and stakeholders. Will be available during regular work hours to communicate with and to provide education and training to DCFS staff and stakeholders regarding managed care, and to engage in immediate problem resolution with Contractor's administrative staff. Will ensure that issues or barriers reported to a liaison must be addressed and the resolution communicated to appropriate DCFS staff or stakeholder. Pay Range: $22.94 - $38.79 per hour At Centene, we connect people to