Care Navigator

Location

Kansas | United States

Job description

Who We Are

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our mission - and our passion - is to improve the lives of the members we serve and be the ideal partner for our providers.

Lucet's unique combination of people and technology has proven to optimize access to behavioral health care providers and increase a health plan's ability to connect members to quality care. With the industry's largest network of care navigators and technology powered by more than six million assessments and more than 20 years of data, Lucet is the only solution proven to successfully identify and connect people across the entire acuity spectrum with the right care in less than five days on average, and often as little as one day.

Our members, providers and partners fully entrust us to deliver outstanding quality care through coordinated behavioral health services, employee assistance programs, organizational consulting, student well-being programs and more.

When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

Job Summary

Care Navigators (CNs) are our company's forefront. They are an empathic, people focused member of the Lucet team that acts as the first point of contact for all inbound member and provider calls. Creating great member experiences during these critical, initial connections, the CN provides information to the caller from intake to triage. They will also act as liaison to other departments within Lucet, assisting with the routing of calls, and providing the essential information to our members and their providers, as needed. This position is responsible for providing the initial connection between our callers and our company, one we feel is very important about the services we provide.

Essential Functions

• Receive initial calls from providers, clients, and members, routing appropriate calls to their respective departments.
• Verify demographic information, and provide benefits, claims, and basic billing/coding information in accordance with HIPPA law. Essential that each CN be able to handle information such as where to send claims, how to identify appropriate benefits, describe product information to providers and members, assist other departments in attempting to solve more basic issues before transferring calls.
• Conduct member assessments and provide bookings through the Lucet booking platform, when appropriate, or provide routine referrals to callers to network providers.
• Triage crisis calls clinical staff for appropriate assistance. Assessing levels of risk beyond the customer service scope.
• Assist with status checks of authorizations for additional services, and basic appeals inquiries.
• Provide routine referrals to callers to network providers. Provide relevant paperwork for providers to adjust demographic information in the system, and to obtain authorization for further treatment for their patients.
• Work simultaneously between multiple systems to provide member/provider mental health benefits.
• Telephonically respond to and resolve routine claims status questions and provide information related to denials or claims submission. Triage to the appropriate staff, department, or third-party administrator when not routine.
• Adhere to department goals and guidelines.
• Achieve performance guarantees with accountability and inspires others through teamwork and collaboration.
• Consistently meet individual metrics as defined by the respective leader and ensure our company contract requirements are met.
• Demonstrate use of MAGIC Customer Service concepts in all communication.
• Willingness to work a variety of shifts, if necessary.
• Create excellent customer service experiences by communicating with respect and precision.
• Work closely with partner teams to remain current on process changes, ensure quick resolution of cross-functional issues, and process improvement.
• Adhere to Lucet Mission Statement, Core Values, Code of Business Conduct and Compliance Program.
• Comply with all Federal and applicable State laws and Lucet policies regarding privacy, confidentiality and security of health information and other designated information.

Job Qualifications

Required

• High School Diploma
• Able to concurrently communicate telephonically and type.
• Ability to create a sense of warmth, openness, and calmness through phone-based communication.
• Ability to establish trust quickly and motivate members through an engaging motivational approach.
• Flexibility in managing conversations around a variety of member needs and presenting concerns.
• Proven written and oral communication skills, organizational skills, demonstrated willingness to work within a collaborative, team-oriented environment.
• Has proven system navigation and problem-solving skills.
• Strong computer skills (MS Office Suite, Adobe Acrobat, and data processing).

Preferred

• 1+ years customer service experience (call center preferred)
• 1+ years medical billing/coding and/or claims experience (mental health preferred)
• 1+ years working in a remote/telework environment.
• Experience with the Genesys Interaction Desktop.
• Working knowledge of health insurance as a whole.
• Bachelor's degree in health-related field.
• Spanish proficiency

Key Competencies

• Ability to show empathy, common courtesy, patience, and respect to all callers.
• Effective communication and active listening skills
• Effective critical thinking and problem-solving skills.
• Ability to work in a team-based environment.
• Effective time management skills and strong organization skills.
• Receptive to open and honest feedback, including a willingness to learn and embracing continuous improvement.
• Ability to work both autonomously as well as a part of a diverse team environment.
• Demonstrates proactive ownership of work by looking to resolve problems without being asked and following assigned tasks and duties to full completion.

Working Conditions

• Work is performed indoors in a home office environment- not substantially exposed to adverse environmental conditions.
• Frequent exposure to VDT screens and computer.
• Physical demands include constant ability to remain in a stationary position, move about inside an office or remote setting, able to communicate and exchange information with others, able to inspect information, and able to perform repetitive motion with arms and fingers.
• Mental demands include constant ability to interpret data, problem solve, make decisions, and organize and plan.

Salary and Other Compensation:

The starting salary that Lucet reasonably expects to pay for this position ranges from $18.00 - $21.00 per hour, depending on circumstances including an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.

This position is eligible for a bonus in accordance with the terms of Lucet's incentive plan based on both company performance and individual performance.

Benefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: Medical, Dental, Vision, 401(k) with competitive employer match, company paid life and disability insurance, company paid gym access, tuition reimbursement, parental leave, PTO (vacation, sick and volunteering), Remote Work.

This position will accept and review new applications and resumes no less than 7 days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.

Job tags

Salary

$18 - $21 per hour