[Remote] Customer Care Navigator, ABA services - remote (PA/NJ/DE)

Note: The job is a remote job and is open to candidates in USA. Independence Blue Cross is hiring a Customer Care Navigator to support families with children served by its Autism Case Management team. The role serves as a point of contact, coordinates referrals and care needs, and helps families understand benefits, authorizations, and community resources.

Responsibilities

• Provide information to inbound members and providers callers regarding Autism, ABA , and other mental health and substance use disorder benefits, community resources, care management programs and services, policies and procedures
• Responsible for making outreach calls to member families to educate them around the Autism Case management program, screen for any care management or referrals, support program document collection, and coordinate with the care managers on member and family care needs
• Collaborate with network providers to identify appropriate referrals for diagnostic, ABA and specialty care
• Provide follow up calls to support appropriate information needed for authorization process
• Coordinates with lead Autism care managers to address identified member and family care needs including attending rounds and team meetings
• Promote quality service delivery and effective care transitions planning for optimal member health outcomes
• Coordinate with Network Operations staff to facilitate access to providers in the Member's area
• Facilitate communications including manual letters and faxes to members and providers to support department needs
• Promotes quality service delivery and reducing the burden member families face in dealing with a long-term disability
• Provides administrative support services to clinical staff and in support of coordinated care and positive care outcomes such as building cases in system to begin Utilization Management process

Skills

• Bachelor's degree in Social Work, Psychology or related healthcare field and three (3) or more years of experience in a health care, or managed care setting
• Strong computer and keyboarding skills (MS Outlook, MS Word, MS Excel, Adobe Acrobat, and data processing), including the ability to document while simultaneously while taking information over the phone
• Excellent written and verbal communication, interpersonal, and organizational skills
• Excellent assessment and engagement skills
• Basic understanding of diagnostic requirements
• Ability to make referrals for testing
• Basic understanding of medical comorbidities
• Familiar with behavioral health/medical terminology
• Self-motivated and the ability to assume a collaborative role in ensuring that all objectives are met
• Ability to work independently to meet team objectives/goals
• Professional demeanor in response to all situations regardless of the nature or circumstances of the situation
• Able to manage multiple tasks in a fast-paced, changing environment
• Ability to work within a collaborative, team-oriented environment
• Bachelor's degree and five (5) or more years of experience in a health care, managed care setting
• Experience working with members with autism or other developmental disabilities and their families
• Bilingual (English and Spanish)

Benefits

• Fully remote; work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Company Overview

• The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross. It was founded in 1938, and is headquartered in Philadelphia, Pennsylvania, USA, with a workforce of 5001-10000 employees. Its website is https://www.ibx.com.