Job Description

ROLE OVERVIEW

As a Government Solutions Autism Care Navigator reporting to a Clinical Steward, you will be a trusted go-to resource for beneficiaries in the Autism Care Demonstration. In this role, you will collaborate and oversee the assessment, planning, facilitation, care coordination, evaluation, and become an advocate for options and services to support a beneficiary’s comprehensive health needs and achieve cost-effective outcomes. You’ll have the opportunity to help beneficiaries get the right care at the right time… no problem is too big or too small.

A DAY IN THE LIFE…

• Become the singular point of contact for a beneficiary and their family, building trusted relationships with them
• Conduct initial and ongoing behavioral and clinical assessments to identify an individual’s unique needs and develop tailored care plans
• Gain a holistic view of who our beneficiaries are, understand what’s important to them and provide options so they can make an informed decision about their healthcare
• Educate beneficiaries on ASD and any of their related co-morbid diagnoses
• Educate on the Autism Care Demonstration and their TRICARE benefits
• Assess for and prevent gaps in care or delays in accessing care
• Monitor and communicate with family/beneficiary on upcoming referrals, authorizations, outcome measures and other program requirements

COORDINATE MEDICAL AND BEHAVIORAL HEALTH SERVICES

• Co-ordinate and collaborate with the beneficiary’s care providers to ensure a cohesive plan is in place
• Ensure any co-morbid diagnosis are treated or addressed by evidenced based medical interventions through TRICARE benefit and/or State/Federal and local level resources
• Drive parent engagement thru access to parent focused programs and available trainings
• Utilize TRICARE specific outcome measures and HNFS clinical necessity review for goal planning
• Address stagnation and/or regression in outcome measure scores with the family
• Participate in medical team conferences with civilian & military primary and specialty care providers

Qualifications

WHAT WE ARE LOOKING FOR…

• A Registered Nurse, Certified Case Manager, Clinical Psychologist, or Licensed Clinical Social Worker with a current unrestricted license.
• A minimum of 5 years of active practice in their respective clinical area
• Clinical experience in pediatrics, behavioral health and/or ASD
• Case Management and Discharge planning experience - Preferred
• Utilization Management & Managed Care experience - Preferred
• Computer strength is a MUST – you’ll be listening, talking, typing – all at one time
• Be an empathetic critical thinker – there are no scripts here – speak with your mind and heart, be able to think outside of the box
• Possess excellent communication skills, organization skills with a high tolerance for change

WHERE PERMITTED BY APPLICABLE LAW, CANDIDATES MUST HAVE RECEIVED OR BE WILLING TO RECEIVE THE COVID-19 VACCINE BY DATE OF HIRE TO BE CONSIDERED, IF NOT CURRENTLY EMPLOYED BY ACCOLADE, INC. THE COMPANY WILL PROVIDE REASONABLE ACCOMMODATIONS TO QUALIFIED EMPLOYEES WITH DISABILITIES OR FOR A SINCERELY HELD RELIGIOUS BELIEF. PLEASE NOTE THAT A REQUEST FOR EXEMPTION DUE TO A PERSONAL PREFERENCE NOT TO RECEIVE A VACCINE IS NOT PROTECTED BY LAW. ALL REQUESTS FOR EXEMPTIONS FROM THIS MANDATE SHALL BE DIRECTED TO THE COMPANY RECRUITER WHO SHALL ROUTE THE REQUEST TO THE COMPANY’S HUMAN RESOURCES DEPARTMENT.

Additional Information

WHAT IS IMPORTANT TO US

Creating an enduring company that is hyper-focused on our culture and making a meaningful impact in the lives of our employees, beneficiaries and customers. The secret to our success is:

WE FIND JOY AND PURPOSE IN SERVING OTHERS

Making a difference in our members’ and customers’ lives is what we do. Even when it’s hard, we do the right thing for the right reasons.

WE ARE STRONG INDIVIDUALLY AND TOGETHER, WE’RE POWERFUL

Trusting in our colleagues and embracing their different backgrounds and experiences enable us to solve tough problems in creative ways, having fun along the way.

WE ROLL UP OUR SLEEVES AND GET STUFF DONE

Results motivate us. And we aren't afraid of the hard work or tough decisions needed to get us there.

WE’RE BOLDLY AND RELENTLESSLY REINVENTING HEALTHCARE

We're curious and act big -- not afraid to knock down barriers or take calculated risks to change the world, one person at a time

All your information will be kept confidential according to EEO guidelines.