Care Navigator

Position Title: Care Navigator 
Assignment Duration: 3 Months (potential to extend or convert)
Work Arrangement: 100% Remote-FL
Schedule: Monday – Friday 8a to 5p / CANNOT BE WORKING ANOTHER JOB OUTSIDE OF THIS ROLE

FTE Salary Conversion Band

$47,700-$64,200K

Responsibilities:

• Develops, assesses, and coordinates care management activities for members diagnosed with HIV/AIDs based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
• Business Growth of members who have HIV/AIDs under the HIV specialty plan.
• The HIV Specialty Plan team at Sunshine Health (“Power to Thrive”) operates within the Care Management department, supporting a high-touch, mission-driven population of members living with HIV/AIDS. The team is highly focused on improving member outcomes, including medication adherence, viral suppression, and engagement in care.  The staff we are looking for is someone who has HIV background or worked with HIV/AIDs members and who is a License Practice Nurse.
• In this role, Care Managers support a moderate-to-high acuity caseload of approximately 150 members enrolled in the HIV Specialty Plan at Sunshine Health. The focus is on delivering ongoing, individualized care management to improve clinical outcomes and member engagement.
  Day-to-Day Responsibilities
• Member Outreach & Engagement
  • Conduct outreach to newly assigned and existing members to complete required HIV assessments and/or Health Risk Assessments (HRA)
  • Maintain consistent follow-up to ensure members remain engaged in care management.
• Assessment & Care Planning
  • Develop individualized care plans based on clinical, behavioral, and social needs
  • Continuously reassess and update care plans as member needs evolve
• Care Coordination
  • Connect members to primary care providers, HIV specialists, and community resources
  • Facilitate scheduling, referrals, and removal of barriers to care
• Medication & Treatment Adherence
  • Provide education and support to ensure compliance with antiretroviral therapy (ART)
  • Monitor adherence and address gaps that could impact viral suppression
• Quality & Outcomes Management
  • Identify and close HEDIS care gaps to improve preventive care and chronic condition management.
  • Focus on improving viral suppression rates and overall health outcomes.
• Performance Metrics are measured by caseloads, number of calls per day/month, notes per day/month, assessments, care plans, phone call and chart audits > 90% monthly, closing open HEDIS care gaps, and overall compliance of caseloads.
• Working with HIV membership focuses on improving Medication adherence (ART compliance), engagement in routine HIV care, and viral suppression outcomes

Candidate Requirements
Required: Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.			Preferred: LPN with HIV background/knowledge (Good bonus)
Required: LPN			Preferred: Care Coordinator, Care Management background experience included with LPN is a PLUS
Years of experience required: 2-4 or more years of experience working in case management or with HIV patients.   Disqualifiers:   Additional qualities to look for: Good communication skills, history in call center or care management work, able to discuss or ask for sensitive information relating to HIV/AIDs.
Top 3 must-have hard skills stack-ranked by importance	1	Fast learner with strong documentation skills and the ability to quickly navigate and adapt to multiple systems. Proficient in Microsoft applications and comfortable working in a technology-driven environment. Experienced in managing a full telephonic workload, including extended headset use, while accurately tracking and documenting activities such as breaks, lunches, meetings, and trainings within phone-based systems.
	2	Strong communication and engagement skills, with the ability to build rapport, educate members, and effectively guide conversations to support care plan adherence and improved health outcomes.
	3	Good time management skills
	4	Ability to navigate well through systems
	5	Proficient in Microsoft Office Suites

 Position is offered by a no fee agency. 
Location : Remote-FL 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $27.00/hr.