Behavioral Health Care Navigator

Description:

Providence Health is calling a Behavioral Health Care Navigator to our location in Beaverton, OR. This position will be remote and may pivot to a hybrid model in 2022 working a combination of in office and remote. We are seeking candidates that are available in commute distance to the office in Beaverton, OR.

We are seeking a Behavioral Health Care Navigator to responsible for performing duties in support of the core functional areas of behavioral health within the Care Management and Utilization Management programs. In this position, you will be the front line responder to inbound calls for behavioral health (BH). Responsibilities will include, but not limited to, providing health care navigation and referral coordination for Members and Providers with chronic health conditions and those requiring mental health assistance or behavioral health assistance. In addition, the Behavioral Health Care Navigator may conduct outreach to Members for enrollment and program engagement as well as processing authorization requests and set up.

MAJOR CHALLENGES:

• Effectively handling the emotional climate when dealing with members and providers regarding denied services that are not covered or do not meet recommended clinical guidelines.
• Navigating the complex health care industry and accessing available community services available to members.
• Staying solution oriented focused on affordable, high-quality care for PHP members.

Patient Population Served: Pediatric, Adolescent, Adult, Geriatric

Consequently, the employee must be competent in the interpretation of a patient’s self-report or behavior, and this information must be interpreted with an understanding of the cognitive, physical, emotional/psychosocial and chronological maturation process. The treatment of patients should be individualized and should reflect an understanding of the developmental needs and range of treatment needs for each patient.

In this position you will have the following responsibilities:

• Receive and triage behavioral health inquiries regarding quality of care, and care management
• Conduct initial outreach for chronic condition program enrollment and participation
• Manage UM/CM call triage and first level clinical need resolution
• Collect Member information to enter into Care Advance system per department policies, procedures and standards of operation
• Act as a department liaison and will provide education, resources, and assistance to members, providers and office staff, payers, and other Health Plan employees to problem solve or address inquiries regarding work, workflow, processes, information system issues and relationships
• Provide appropriate education for patient, family and staff regarding community support systems
• Educate callers about PHP Behavioral Health benefits and services
• Manages clinical coordination cases including risk assessments, emergency department follow up, member screening for Care Management services.
• Coordinate care for members needing assistance with accessing health care services, providers, community services, or other resources.
• Provide resources and referrals to community agencies.
• Assist the department in meeting contractual and or performance goals.
• Stay informed of new policies and procedures within CM/UM.
• Satisfactorily complete all required training.
• Promote a positive, respectful and helpful demeanor to Members and staff.
• Identify complaints and assist patients to exercise grievance rights.
• Interacts with providers and payers to coordinate patient care and resolve authorization issues.
• Interacts with clinical CMs, claims, UM team, Customer Service, and provider relations departments in order to serve callers effectively.
• Other duties as assigned.

Qualifications:

Required qualifications for this position includes:

• Two (2) years Managed Care or a facility based health care setting, working with patients/members, preferably within a mental health related field
• One (1) year Experienced in behavioral health and social determinants of health navigation and care coordination
• Two (2) years Certified Nurse Assistant, Certified Medical Assistant, preferably within a mental health related field, Certified Crisis Interventionist, or equivalent experience per manager discretion

Preferred qualifications for this position includes:

• Bachelor’s Degree Health Related Field
• Experience in crisis intervention, Trauma Informed Care, Motivational Interviewing
• Current Level Tech III or Clinical Support Coordinator
• Experience with Community Services, Safety Net Services, or Vulnerable Population programs

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct

or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

“Providence will provide the best care and service to every person, every time.”

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

We offer a full comprehensive range of benefits — see our website for details — http://www.providenceiscalling.jobs/rewards-benefits

We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Behavioral Health

Location: Oregon-Beaverton

Other Location(s): Oregon

Req ID: 348814