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Behavioral Health Service Navigator

Company: Point32Health
Location: Home
Posted on: November 22, 2022

Job Description:

Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities.
Job Summary
Under the general direction of the Manager, Behavioral Health Operations and Member Experience, the Behavioral Health (BH) Service Navigator (SN) is responsible for providing short-term, personalized Behavioral Health support to members which involves education, and access to care according to program requirements, regulatory requirements and department service level agreements for all lines of business.
In this role, the BH SN answers member communications that are warm transferred by Member Services or via email. The BH SN will conduct an initial assessment with the member to develop personalized, non-clinical goals and action steps. The BH SN will support the member in reaching their goal, which may be obtaining an appointment with an outpatient BH provider or a referral to a BH digital or in-person point solution. The BH SN will outreach to providers as needed to assist the member in accessing care. The BH SN will follow department policies, procedures and training documentation and will follow documentation standards and expectations. The BH SN may participate in internal projects and update workflows. The BH SN presents a consistent and professional demeanor to all callers and internal customers and is expected to identify opportunities to further improve customer service and efficiency.
The BH SC is expected to take responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention, and satisfy corporate goals and objectives. The BH SC be exposed to and required to deal with highly confidential and sensitive information and must adhere to corporate compliance policy and department guidelines/policies and all applicable laws and regulations at all times.
Key Responsibilities/Duties - What You Will Be Doing

  • Promptly responds to warm transfers and communications to BH SN Program team.
  • Develops a professional rapport with members, conduct initial non-clinical assessment, develop behavioral health goals and action items to support members in meeting navigation goal (i.e., BH outpatient appointment, referral to point solution, etc.).
  • Engages members by utilizing skills, including but not limited to, motivational interviewing to identify their current needs and develop goals and action steps. This may include follow up on calls to achieve navigation goals.
  • Outreaches to providers as needed to assist the member in accessing care.
  • Resolves issues and inquiries received by the BH Service Navigation Program.
  • Documents calls in clinical case management systems (i.e., MHK, Jiva) following documentation standards.
  • Works collaboratively as needed with partner departments to support the coordination of the member's care.
  • Participates in internal meetings and projects as needed.
  • Makes recommendations for program improvements.
  • Other duties and projects as assigned.
    Qualifications - What You Need To Perform The Job
    • Bachelor's degree from accredited educational institution required, (degree in psychology, social work, counseling or healthcare preferred).
    • 2-3 years of relevant healthcare work experience, in a customer service and/or behavioral health setting.
    • 12 months health insurance experience (preferred).
    • Prior experience training and working in a virtual/remote setting is strongly preferred.
    • Excellent customer service and member engagement skills.
    • Excellent verbal communications and writing skills.
    • Ability to manage escalated calls and issues.
    • Must be able to work cooperatively as a team member. Excellent interpersonal skills.
    • Must be able to adhere to strict confidentiality in the handling of patient health information, internal business information, and provider payment information. All information (written, verbal, electronic, etc.) that an employee encounters while working at Point32Health is considered confidential.
    • Must be able to exercise appropriate judgment as necessary.
    • Ability to develop goals to target members' personalized needs.
    • Develop and maintain working knowledge of BH resources, per line of business, and offer these to members when applicable for timely solutions.
    • Requires a high level of initiative and ability to analyze business processes.
    • Ability to quickly learn and use various computer systems, software, and programs.
    • Ability to work on a computer and telephone simultaneously.
      Working Conditions And Additional Requirements
      • Must be able to work under normal office conditions and work from home or office as required.
      • Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
      • Schedule may vary or reflect non-standard business hours, according to business needs.
      • This is a remote position that will require ad hoc in office presence based on business need (i.e., BH Department All Staff meetings).
        The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.
        Commitment to Diversity, Equity & Inclusion
        Point32Health is committed to making diversity, equity, and inclusion part of everything we do-from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
        COVID Policy
        Please note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

Keywords: Point32Health, Topeka , Behavioral Health Service Navigator, Healthcare , Home, Kansas

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