UPMC Health Plan and Workpartners is hiring a temporary Contact Center Navigator. This role will work Monday - Friday (Mondays and Friday standard daylight hours EST, Tuesday - Thursday 12 pm - 9 pm EST) and may work remotely. This role will not be eligible to work overtime.
The budgeted hourly range for this position is $27.89–$35.00.
The ideal candidate will possess the following:
• BSN
• Active RN
• ER, Psych, and/or School nursing experience is a bonus.
• Bilingual in Spanish is a bonus.
• Prior experience working remotely.
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. Collaborates with and facilitates 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. The Contact Center Navigator is the first clinical contact for members identified as KnovaSolutions referrals.
Responsibilities:
- Completes Annual Competencies including Ethics and Compliance, HIPAA, Safety, Fraud and Abuse and Confidentiality/Privacy and Security Awareness. Preserves confidentiality of the member.
- Utilizes independent problem solving and demonstrates ability to propose and implement creative solutions to member problems in order to achieve a high level of member satisfaction with KnovaSolutions.
- Completes timely and accurate documentation of member contacts in the SMA health record.
- Identifies health behaviors, risk factors or other concerns that would potentially improve members health if enrolled in the service.
- Initiates outbound contact and responds to inbound contact with identified members to facilitate enrollment in KnovaSolutions.
- Refers members to Company Benefits.
- The Contact Center Navigator provides clinical triage of members to KnovaSolutions Clinical Prevention Specialists. Conducts initial health assessments using motivational interviewing techniques or other behavioral change skills.
- Bachelor's degree in behavioral, social work, nursing, public health or a related field strongly preferred
- 2 years of experience in counseling, clinical assessment, care coordination, coaching, and/or care management strongly preferred
- Active RN licensure strongly preferred.
- Bilingual in Spanish is a bonus.
- 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.
Licensure, Certifications, and Clearances:
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran