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GEHA Healthcare Navigator in Lee’s Summit, Missouri

GEHA is a leader in health services for federal employees and related customers, serving our chosen markets with low-cost offerings and best-in-class customer care, sustained by a nimble and efficient organization.

As a condition of employment, all GEHA employees must be fully vaccinated against COVID-19 unless a medical or religious exemption is approved.

Works collaboratively with care team to provide support, health education, and care coordination services to members and their families using an empowerment approach to promote positive change and participation in their health. Engages and educates members about available programs, additional resources, and GEHA services. Identifies cases for internal and external care management/cost-containment programs. Documents case information in appropriate systems

SKILLS

Duties and Responsibilities

  • Collaborates with care team utilizing appropriate tools to prioritize workload.

  • Conducts follow-up to assist members with reaching goals and closing gaps in care.

  • Facilitates appropriate use of resources to impact the cost of care. Coordinates necessary services to improve health status for members across teams.

  • Identifies member needs for and refers to appropriate internal and external programs. Redirects providers and members to in-network facilities when available.

  • Provides support, empowerment, education and care coordination services to identified members as designated.

  • Assists members with contacting providers, community agencies other care management professionals and appropriate GEHA resources.

  • Accurately documents work with members in appropriate systems following policies and procedures.

  • Communicates with facilities as needed to support transitions of care and follow-up.

  • Identifies complex care issues and refers to care team nurse.

Requirements: Education & Experience

  • Requires two years (60 credit hours) of college

  • Additional years of qualifying work experience may be considered in lieu of formal education

  • 5 years experience in a clinical setting, human services, care management or healthcare call center in addition to 1 year utilization or knowledge of claims processing

  • Ability to work as part of a multidisciplinary team

  • Requires effective written and verbal communication skills

GEHA is an Equal Opportunity Employer. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. Our company's corporate headquarters is located in Lee's Summit near Douglas Rd and I-470 with a total of five locations in the Kansas City metropolitan area.

GEHA is a leader in health services for federal employees and related customers, serving our chosen markets with low-cost offerings and best-in-class customer care, sustained by a nimble and efficient organization.

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