Contact Center Navigator- WorkPartners/ HCMS

WorkPartners
Published
April 16, 2019
Location
Loveland, CO
Job Type

Description

UPMC Health Plan is hiring a full-time Contact Center Navigator to help support the WorkPartners HCMS Department. This role requires both daylight and some evening shifts.

The KnovaSolutions Contact Center Navigator is responsible for care coordination, health education and assessment for identified KnovaSolutions members through telephonic and other electronic collaboration with members. The navigator's role is to be the first clinical contact for members identified as KnovaSolutions referrals. Duties involve conducting initial health assessments, in-the-moment education sessions, stage of change identification, and clinical triaging of members to KnovaSolutions nurses, other Life Solutions resources, or other resources available to them as appropriate. In addition to assessment and triage, coaches will deliver targeted, one-time education sessions around a variety of health-related topics (e.g. stress management, making changes to diet, increasing healthy steps, shared decision making, managing depression, finding a medical home, etc.) They will initiate outbound contact and respond to inbound contact with identified members for the purpose of Identifying members' medical, behavioral, and social needs and facilitating enrollment in KnovaSolutions. The position will collaborate with and facilitate coordination with KnovaSolutions nursing and pharmacy staff, other departments, providers, community resources and caregivers to provide additional support. Members will be followed by telephone or other electronic communication methods.

Responsibilities

  • Completes Annual Competencies including Ethics and Compliance, HIPAA, Safety, Fraud and Abuse and Confidentiality/Privacy and Security Awareness. Preserves confidentiality of the member.
  • Completes timely and accurate documentation of member contacts in the SMA health record.
  • Conducts an initial health risk assessment and discusses interventions that could mitigate risk
  • Employs engagement strategies that encourage individuals to explore motivation for change, enhance readiness and develop competence in the use of behavior change skills.
  • Identifies health behaviors, risk factors or other concerns that would potentially improve members health if enrolled in the service.
  • Provides one-time or on-the-spot coaching interventions for moderate or low risk members. May refer to other health and wellness programs based on the member's needs.
  • Receives and responds to complex calls regarding requests for KnovaSolutions services. Has expertise in assessing risk levels.
  • Reviews members' health information, service availability, barriers, and readiness; triages members to the KnovaSolutions Nurse or other intervention based on those variables.
  • Utilizes independent problem solving and demonstrates the ability to propose and implement creative solutions to member problems in order to achieve a high level of member satisfaction with KnovaSolutions. 

Qualifications

  • Behavioral, social work, public health or a related field required.
  • Masters degree in a human services field preferred.
  • Two years of experience in counseling, clinical assessment, care coordination, coaching, and/or care management required.
  • Previous Health Coaching experience is highly preferred
  • Knowledge of or ability to learn a family-centered counseling approach that emphasizes nonjudgmental empathic interaction and collaborative development and implementation of behavior change plans.
  • Basic knowledge of workplace benefits, insurance reimbursement and EOBs
  • Detail-oriented individual with excellent organizational skills.
  • High level of oral communication skills.
  • Competently employ motivational strategies for encouraging individuals to explore motivation for change and enhance readiness.
  • Intermediate proficiency with MS Word and Outlook.
  • Ability to learn new computer-based documentation skills.
  • Excellent verbal and written communication and interpersonal skills required.

Company Description

WorkPartners helps clients understand their employees’ real health needs and behaviors.

Did you know that 5 percent of your employee population is driving 55 percent of your total human capital costs?

Using integrated, advanced data analytics with award-winning clinical prevention services, we don’t just identify the employees most in need of help—we provide the health care solutions they need. This results in healthier, more productive employees and mitigation of your health care costs.

Our services include:
• Data analytics.
• Employee assistance services.
• Health management services.
• Absence management services.
• Short-term disability and third-party administrator services.
• Nurse case management.
• Workers’ compensation.
• On-site health services.

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