Job Details

Title - Care Navigator

Shift - Mon to Fri | 8 am to 5 pm or 9 am to 6 pm

Location - Greenville and Spartanburg area of SC.

Health plan : Absolute Total Care

Does this job require field operation/visits - Yes

Story Behind Job

This is a new line of business from the state managing Medicaid Seriously Mentally Ill (SMI) members from ages 6-64 years of age. Members require at least 1 phone call monthly, 1 visit every 90 days and an annual assessment. Case Navigators are allowed a of caseload of no more than 60 members due to the intensive nature of the members. Purpose of plan to assure members are receiving all medications, attending all MD/ mental health clinic appts, have adequate housing and transportation to attend all appts.

This project has a go live date of 7/1/25. Since there is a cap on the amount of cases a CN can have we anticipate ongoing hiring needs. CN are responsible for the unable to locate population and will be conducting all research necessary to locate the members.

Typical Day in Role

• Schedule of 8 hours daily.
• CN will make calls, visits and coordinate care for members.
• Our work is driven by metrics from the state that all are time driven. We currently have 12 CNs. They will be issued a company owned computer and cellphone. The team interacts with one another thru Teams, calls or texts.
• All team members have “buddies” that also work in the same area and are available for co-visits.

Education/Certification : Bachelor's Degree, and Certified Community Health Worker.

Must haves: Bachelor's Degree

Nice to haves: A background in Behavioral Health (BH) is helpful, Case Management experience, Home Health Visit, Field Safety Training

Disqualifiers: Unwilling to do blind visit. Must be willing to travel.

Performance indicators: Able to meet strict deadlines related to documentation/visits/calls.

Top 3 skills

• Ability to handle frequent change in policies and procedures
• Work independently to meet metrics
• Team collaboration