Care Navigator - REMOTE

Job Title: Care Navigator Job Description This role develops, assesses, and coordinates care management activities based on member needs to support quality, cost-effective healthcare outcomes. The Care Navigator creates or contributes to personalized care and service plans, connects members with appropriate providers and community resources, and educates members and their families or caregivers on available services and benefit options. Through advocacy and care coordination, this position helps members improve access to healthcare and receive appropriate, high-quality care. Responsibilities Evaluate members’ needs, identify barriers to care, assess available resources, and recommend and facilitate a care plan that supports the best possible outcomes. Develop or contribute to personalized care and service plans, including ongoing updates, and identify appropriate providers, specialists, and community resources needed to support member care. Provide psychosocial and resource support to members, caregivers, and care managers to help them access local services such as employment, education, housing, food, participant-directed services, independent living, justice-related resources, and foster care, based on service assessments and plans. Coordinate, as appropriate, between members, families or caregivers, and the care provider team to ensure that identified care and services are accessible in a timely manner. Monitor progress toward care and service plan goals and track changes in member status or condition; collaborate with healthcare providers to revise care or service plans as needed and refer members to care management for further evaluation when appropriate. Collect, document, and maintain all member information and care management activities in accordance with current state, federal, and third-party payer regulations. Perform on-site visits, when required, to assess member needs and collaborate with providers or community resources. Provide education to care managers, members, and families or caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits. Support crisis intervention and crisis management efforts as needed, ensuring members receive appropriate and timely support. Use care management platforms or healthcare CRM systems to manage caseloads, document interactions, and track member outcomes. Engage in telephonic outreach to members as part of care navigation, care coordination, and population health initiatives. Work effectively within a call center healthcare environment to respond to member needs and support care management programs. Perform other duties or responsibilities as assigned to meet member and business needs. Comply with all organizational policies, procedures, and standards. Essential Skills Bachelor’s degree in Social Work, Psychology, Human Services, Behavioral Health, or a related field. Minimum 1 year of experience in Care Navigation, Care Coordination, Case Management, Member support, Population Health, Behavioral Health programs, or health plan/member services involving telephonic outreach. Experience with care management, care coordination, and care navigation for diverse member populations. Proficiency using care management platforms or healthcare CRM systems to document and track member interactions and outcomes. Experience managing a caseload in a healthcare or behavioral health setting. Experience in behavioral health, including working with members with psychosocial or behavioral needs. Experience with telephonic outreach to engage members, coordinate care, and provide education. Crisis intervention and crisis management skills to support members experiencing urgent or complex situations. Knowledge of Medicaid or managed care programs and related processes. Experience in population health or programs focused on improving health outcomes for defined member groups. Experience working in a call center healthcare environment or similar high-volume, member-facing setting. Strong ability to assess member needs, identify barriers to care, and connect members with appropriate community resources. Effective written and verbal communication skills to educate members, caregivers, and care teams. Ability to coordinate care among multiple providers, specialists, and community partners. Strong organizational and documentation skills to ensure compliance with state, federal, and third-party payer regulations. Additional Skills & Qualifications Behavioral Health experience is strongly preferred. Telephonic outreach experience in a healthcare or health plan setting is strongly preferred. Crisis intervention and crisis management experience is strongly preferred. Experience with Medicaid or Managed Care programs is strongly preferred. Population health experience, including working with defined member populations and outcome-focused programs, is strongly preferred. Experience in a call center healthcare environment is strongly preferred. Familiarity with local community resources related to employment, education, housing, food assistance, independent living, justice system support, and foster care services. Ability to build rapport and trust with members and caregivers from diverse backgrounds. Comfort working both independently and as part of an interdisciplinary care team. Strong problem-solving skills and the ability to adapt care plans as member needs change. Work Environment This is a remote position with core hours of Monday through Friday, 8:00 AM to 5:00 PM. The role requires residency within approximately 45 minutes of the Atlanta office, as occasional onsite presence may be required for meetings. Work is primarily performed using care management platforms and healthcare CRM systems, along with telephonic outreach and other virtual communication tools. The environment is similar to a call center healthcare setting, with a focus on timely response to member needs, coordination with care teams, and adherence to regulatory and organizational standards. Job Type & Location This is a Contract position based out of Atlanta, GA. Pay and Benefits The pay range for this position is $23.00 - $26.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Sep 30, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.