Care Navigator I
One Call

Job Info

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Care Navigator I

We're looking for colleagues who are ready to Think Big, Go Fast, Deliver Awe,and Win Together. These core values embody our diverse and inclusive culture and help us live out our mission of "getting people the care they need when they need it." Over the last 30 years, our company has established itself as the market leader in managed care for the workers' compensation industry. We are committed to making a positive impact in the lives of the injured workers we serve, and we have fun doing it.

Salary Range: $19.04 - $28.56Hourly

This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $19.04 - $28.56Hourly

Benefits Summary:
In return for your commitment to our company's mission, we offer a vast array of benefits to help support the whole you.

• Opportunities to work from home

• Competitive wages with opportunities to earn annual merit increases

• Paid development hours to use for professional and community development!

• Generous paid time off, 8 company holidays, and 2 floating holidays per year

• $1,000 Colleague Referral Program

• Enterprise Recognition Program rewarding colleagues for their extraordinary work

• Exclusive discounts on travel, activities, and merchandise via work discount program

• Colleague Assistance Program that provides free counseling and financial services

• Tuition Reimbursement Program including certifications

• Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions

• Medical, dental, and vision insurance

• Pre-Tax FSA and HSA health savings accounts

• 401(k) matching

• Company paid life insurance

• Company paid short term and long-term disability

• Referral program

• Healthcare concierge

• The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters.

This role is an internal case management support to ensure that One Call customers are being provided the best continuum of care for their injured workers. This associate will work with all business units to ensure that services are provided timely and at the best cost based on the clinical needs of the injury/injured worker. Provides support to the carrier in coordination of injured workers until the case is closed by the carrier and/or discharged by the physician.

Entry level role. Basic skills with moderate level of proficiency. Generally, performs a high volume of basic inquires about One Call products and services by following standard scripts and procedures. Consults with senior peers and team leads on non-complex issues to learn through experience.

GENERAL DUTIES & RESPONSIBILITIES:

Analysis and Review 70%

• Management of work-related injuries, which includes assessment, planning, coordination, implementation, and evaluation of injured worker
  
• Initial review of a referral includes conducting a customer call that provides an overview of injured worker needs, the plan of care, and steps being taken to mitigate injured worker health care needs
  
• Determines injured worker needs by completing interviews; reviewing documentation, collaborating, determining need for area of evaluations; reviewing evaluations, treatment objectives, and plans.
  
• Establishes treatment programs by setting schedules and routines; coordinating services being provided; arranging resources, including transportation and escorts.
  
• Monitors cases by verifying clients' attendance; observing and evaluating treatments and responses; advocating for needed services and entitlements; obtaining additional resources; intervening in crises; providing personal support.
  
• Reviews records by reading discipline notes; internal documentation, medical records and logging events and progress.
  

Collaboration 10%

• Accomplishes injured workers care by assessing treatment needs; developing, monitoring, and evaluating treatment plans and progress; facilitating interdisciplinary approaches; monitoring provider performance
  
• Communicates clients' progress by conducting meetings and evaluations; disseminating results and obstacles to therapeutic team, customer, and injured worker; identifying treatment influences.
  
• Collaborates with appropriate One Call department(s) of referrals requiring their expertise.
  
• Improves staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluating the application of learning to changes in treatment results.
  
• Prepares injured worker discharge by reviewing and amplifying discharge plans; coordinating discharge and post-discharge requirements; orienting and educating family members; providing resources.
  

Process improvement/Problem Solving 10%

• Improves treatment results by studying, evaluating, and re-designing processes; implementing changes;
  
• Prepares reports by collecting, analyzing, and summarizing treatment and results data and trends; compiling statistics;
  
• Monitors referral expenses; implementing cost-saving actions.
  

Development 10%

• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
  
• Enhances department and organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
  
• Assists in training new associates as requested by Nursing Department Training Leader.
  
• Performs special projects as assigned and prioritized by management.
  
• Improves staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluating the application of learning to changes in treatment results.
  

EDUCATIONAL AND EXPERIENCE REQUIREMENTS:

• R.N., L.P.N., or M.A. with a minimum of two (2) years of experience or the equivalent combination of One Call processes and education
  

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

• Knowledge of the company's products, services and business operations to enable resolution of customer inquiries
  
• Excellent customer service skills that build high levels of customer satisfaction
  
• Excellent communication skills- written, verbal and interpersonal
  
  
• Computer navigation and operation skills
  
• Demonstrates effective people skills and sensitivities when dealing with others
  
• Ability to work both independently and in a team environment
  
• Excellent organization and timeline adherence skills
  
• Ability to analyze information
  
• Ability to make decisions based on injured worker medical need and customer request
  
• Excellent research skills
  
• Ability to resolve conflict
  

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT:

• For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear.
  
• For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear.
  
• The employee is occasionally required to stand, walk, and lift objects (up to 10lbs weight; up to 4 ft. height).
  
• Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus
  
• The work environment utilizes florescent lighting; noise level is moderate.
  
• The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload.
  
• Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position.
  
• Please be advised this job description is subject to change at any time.
  

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