About the position
The Medicaid Member Navigator primarily aids newly enrolled individuals and their families to successfully access health care services within Kaiser Permanente, and to assist members in accessing non-KP services within the community at large. Further duties include, on-going support to ENCC clinical staff concerning a variety of OHP eligibility research issues, as well as providing non-clinical member support designed to address complex socio-economic needs impacting member health and health care. Navigators coordinate and support various department specific projects and programs as directed. They also connect members to vetted community agencies and resources for support and assistance with various needs. Navigators are highly trained communicators and subject matter experts, utilizing Motivational Interviewing to deliver ongoing community resource knowledge. Navigators collaborate extensively within the KP system and larger community to overcome logistical barriers and increase care quality, improve care continuity, and reduce care costs.
Responsibilities
- Provides orientation to the KP integrated care system and PCP model for all new Kaiser Medicaid members.
- Identifies members with unmet needs or active concerns through a telephonic screening process.
- Develops relationships with community agencies and relevant healthcare programs.
- Develops collaborative relationships with staff across departments within KP and externally.
- Actively develops, coordinates and supports various departmental projects and programs.
- Participates in and consults with inter-disciplinary care teams to support complex members.
- Performs necessary functions to ensure member coverages are appropriately assigned and maintained.
- Responds to referrals from various departments to support members with non-clinical barriers to care.
- Provides general administrative support to the Medicaid program through recordkeeping and scheduling.
Requirements
- Strong communication skills and ability to engage with diverse populations.
- Experience in healthcare or social services, particularly in a community setting.
- Knowledge of Medicaid and healthcare systems.
- Ability to work collaboratively with interdisciplinary teams.
- Proficiency in using eligibility databases and documentation systems.
Nice-to-haves
- Experience with Motivational Interviewing techniques.
- Familiarity with community resources and agencies.
- Background in case management or care coordination.
