CareFirst Careers

Wellness Navigator (DC Medicaid)

Resp & Qualifications

POSITION OVERVIEW 

Provides exceptional customer service to members, in person and / or by phone. Works closely with members as informed advocates or liaisons to guide patients through the health care system and connects them to community resources. Assist with community events and outreach initiatives for THP. The Navigator is responsible for event execution; gathering event information, event and marketing promotion as well as assessment of health education needs.


ESSENTIAL DUTIES AND RESPONSIBILITIES 
• Acts as a non-clinical member wellness navigator to assist members in accessing healthcare services, community wellness programs, community resources unknown or otherwise unavailable to members without appropriate referrals.

• Helping and engaging members, (both over the phone and in-person), in facilitating the provision of care as well as utilization of resources including wellness classes.  

• Coach and educate members about health improvement and help develop strategies for obtaining better health, educate about and coordinate community resources

• Accurately maintains daily contact logs, per department policy, regarding client activity and destinations.

• Provides members with culturally appropriate health resources and health information.

• Facilitates efforts related to Health Education including the coordination of meetings, monitoring and assisting with Health Education related programs and related activities.

• Collaborates with staff in Medical Management, Provider Services and Customer Services Departments to ensure implementation and educate membership population of community-based health education programs.

• Facilitate member empowerment and quality of life by promoting educated independent, member choice on care.

• Maintains databases, mailing lists, telephone networks, and other information to facilitate the functioning of outreach program.

• Maintains accurate daily documentation in database(s) of members who participated in the health education classes/ workshops, the number of members outreached to, number of health fairs/community events participated in. • Provides monthly reports on enrollment and attendance for Health Education classes and programs.

• Assists with evaluation of classes and conducts member satisfaction surveys at least annually.

• Recommends educational brochures and other printed materials to educate members on diverse topics such as post-partum care, EPSDT services, disease management programs and HEDIS initiatives.
• Participates in community programs and external meetings representing Trusted and in internal activities that improve HEDIS compliance.

• Establishes working relationships with practitioners and providers to encourage member referrals for health education programs.

• Provides assistance with developing comprehensive, focused, continuous program to meet organizational performance goals for HEDIS and EPSDT.

• Maintains a basic knowledge of upcoming events, services and information regarding the Center and THP and Community collaborative events/ programs.

• Guides each assigned member in the appropriate supports needed to maximize health and wellness
.


QUALIFICATIONS

  •  Two (2) years’ experience in community relations, outreach and Customer services
  •  Must be able to read and write proficiently 
  •  Proficient in Amharic (read and write)



EDUCATION/CERTIFICATIONS

  •  High School Diploma (Required)
  • BS (preferred). 
  • Community Health Worker Certification (preferred)



COMPETENCIES

To perform the job successfully, an individual should demonstrate the following competencies: Analytical   | Collects and researches data; Uses intuition and experience to complement data. Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. Project Management   | Communicates changes and progress; Completes projects on time and budget. Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others. Customer Service   | Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Interpersonal Skills   | Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Oral Communication   | Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Written Communication   | Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Able to read and interpret written information. Quality Management   | Demonstrates accuracy and thoroughness. Diversity   | Shows respect and sensitivity for cultural differences; promotes a harassment-free environment. Ethics   | Treats people with respect; Keeps commitments; inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Organizational Support    | Follows policies and procedures; Completes administrative tasks correctly and on time; supports organization's goals and values; Supports affirmative action and respects diversity. Strategic Thinking - Develops strategies to achieve organizational goals; Understands organization's strengths & weaknesses; Analyzes market and competition; Adapts strategy to changing conditions. Judgment   | Displays willingness to make decisions; Includes appropriate people in decision-making process; makes timely decisions. Motivation   | Sets and achieves challenging goals; Demonstrates persistence and overcomes obstacles. Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources. Professionalism     Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Quality     Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. Safety and Security - Observes safety and security procedures; Reports potentially unsafe conditions. Adaptability   | Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. Attendance/Punctuality | Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time. Dependability   | Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. Initiative   | Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.

OTHER SKILLS LANGUAGE SKILLS   |

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public.

MATHEMATICAL SKILLS |

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

COMPUTER SKILLS|

To perform this job successfully, an individual should have basic computer skills and knowledge of electronic equipment, hardware, software, including applications and data entry.

PHYSICAL DEMANDS |

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; climb or balance; stoop, kneel or crouch. 

The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

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Department

Department:

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Closing Date

Please apply before: 6/14/2020

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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