LTSS Care Navigator

Immediate need for a talented LTSS Care Navigator. This is a 06 Months Contract opportunity with long-term potential and is located in U.S.(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-90891

Pay Range: $20 - $22/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• Shift Time & Working Days. Shift time: 9:30 A.M. - 6:00 P.M. CST with a morning 15-minute break, 30-minute lunch and an afternoon 15-minute break. (This is the closing shift and currently the only option available.)
• Training schedule is between the hours of 8:00 A.M. – 5 P.M.
• OT potential, for this shift would be before shift, based on business needs and not guaranteed.
• Take calls all day in a remote call center, OT will be based on business needs
• Inbound call center, assist and educate individuals/legally authorized representatives in the STAR Kids Medicaid program on LTSS benefits and services such as MDCP, PCS, DAHS, Respite, (LTSS list not all inclusive) and DME requests.
• Remote call center, engagement via Teams
• Each day they will interact with different members/legally authorized representatives and providers, assisting with their LTSS needs or authorizations.
• The team consists of 11 dedicated SCs to STAR Kids, who have also cross trained to handle STAR PLUS calls.
• Each member case is unique.
• Specialized Knowledge in Medicaid Managed Care
• Staff gain deep familiarity with Texas Medicaid programs, especially STAR Kids, which serves children and young adults with disabilities.
• They learn about LTSS (Long-Term Services and Supports), service coordination, and waiver programs—knowledge that’s highly transferable within healthcare and social services.
• Enhanced Communication & Empathy Skills
• STAR Kids members and families often face complex medical and social challenges. Supporting them helps staff develop:
• Empathetic listening
• Clear and compassionate communication
• Crisis de-escalation and problem-solving
• Exposure to Care Coordination Processes
• Staff often collaborate with service coordinators, providers, and other stakeholders.
• They gain insight into interdisciplinary care planning, which is valuable for roles in case management, social work, or clinical support.
• Regulatory & Compliance Awareness
• STAR Kids is governed by strict state and federal guidelines.
• Staff become familiar with HIPAA, Medicaid regulations, and quality assurance protocols, which are essential in any healthcare setting.
• Career Development Opportunities
• The experience can serve as a stepping stone to roles in:
• Care management
• Utilization review
• Member advocacy
• Training and quality assurance
• Cultural Competency & Diversity Training
• STAR Kids serves a diverse population, including non-English-speaking families and those with varying cultural backgrounds.
• Staff build cultural sensitivity and inclusive communication skills, which are increasingly valued in all industries.

Key Requirements and Technology Experience:

• Skills-Call Center Experience: Prior experience in a call center environment is essential.
• Experience with Children/Youth: Must have worked with children or youth for at least 3 of the past 5 years.
• 4 years’ experience, call center, Medicaid and worked with MCO Insurance
• Required: HS Diploma
• Must haves:  good attendance, call center background; worked with MCO insurance
• Nice to haves: background in Service Coordination, and call center experience. 
• Software Skills: Will be using various software on the job: Microsoft Office Suite, Avaya, Zoom, Skype
• Call Center Experience: Prior experience in a call center environment is essential.
• Experience with Children/Youth: Must have worked with children or youth for at least 3 of the past 5 years. (This is contractual – if a candidate does not have at least 3 years of experience working with children or youth, an offer will not be extended.)
• Strong Documentation Skills: Ability to document calls using complete sentences, proper punctuation, and correct grammar.
• Excellent Listening Skills: Attentive and responsive listening is a key part of this role.
• Call Handling Focus: The primary responsibility is managing incoming calls. Candidates must be comfortable wearing a headset for the entire shift and have a quiet, dedicated workspace.
• Medicare/Medicaid Knowledge: Familiarity with Medicare and Medicaid programs is preferred.
• Work Schedule: Must be available to work a consistent shift from 9:30 AM to 6:00 PM.
• Critical Thinking Skills: Ability to assess caller needs quickly, make sound decisions to assist members and providers, escalate issues appropriately, adapt to unexpected situations.
• Computer Knowledge – Avaya, Microsoft applications are key
• Insurance, MCO background.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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