Description

About Us

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what's right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

Benefits

Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:

• Eligibility on day 1 for all benefits
• Dollar-for-dollar 401(k) match, up to 5%
• Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more
• Immediate access to time off benefits

At Baylor Scott & White Health, your well-being is our top priority.

Note: Benefits may vary based on position type and/or level

Job Summary

The Member Navigator works directly with members who have chronic health issues, gaps in care, or are difficult to engage. Guides these members through the health care system and overcomes non-clinical obstacles preventing their care. Works closely with teams across departments, provider offices, and community resources to ensure timely delivery of quality, accessible health care services.

Essential Functions of the Role

• Reaches out to and engages members by phone and other methods. Establishes a trusting relationship with members. Works with members to assess barriers preventing them from receiving needed care and treatment. Serves as member advocate and facilitator in overcoming barriers to care. Creates connections between members, health care providers, community resources, and case management staff as needed.
• Conducts member screenings and refers to case management if clinical needs are identified.
• Maintains appropriate documentation of member contact, referrals and outcomes. Verifies and updates member demographic information.
• Performs quality assurance reviews and trend studies. Initiates process corrections and training requirements. Sets goals for improvements. Conducts regular assessments of the navigation program. Identifies weaknesses and works across health plan departments. Creates and deploys strategies to improve program quality.
• Builds partnerships with teams across departments, provider offices, and community resources. This fosters timely delivery of quality, accessible health care services.
• Continuously expands knowledge and understanding of health plan services and benefits, provider network, and community resources.
• Develops scripts, process flows, etc. for member outreach.

Key Success Factors

• Experience as a community health advocate and/or navigator.
• Naturally attuned to the people and community being served.
• Knowledgeable about the environment, healthcare system and community resources.
• Skilled in developing and maintaining effective relationships with providers, administrative, and professional staff. This fosters timely delivery of quality, accessible health care services.
• Excellent verbal, written and electronic communication skills required.
• Proficient in all Microsoft applications, including Word, Excel, and PowerPoint.
• Skilled in data collection, research and report writing.
• Able to work autonomously with minimum supervision, in a fast paced environment with clear focus on program priorities.
• Able to exercise initiative, judgment, problem solving and recommendation making skills.
• Excellent time management skills with the ability to meet deadlines.

Belonging Statement

We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve.

QUALIFICATIONS

• EDUCATION - Associate's or 2 years of work experience above the minimum qualification
• EXPERIENCE - 3 Years of Experience