Experience

Sarah Tuxis Residential

• Direct Support Professional



Fallon Health

• United States
• Insurance
• 700 & Above Employee

• Navigator/Clinical Care Coordinator

  • Feb 2018 - Present

  .Perform tasks and actions to ensure all CMS and State member related regulatory mandates are met including but not limited to welcome calls, care plans, health risk assessments for the ‘Community Well’ member population, and member service plans according to Program Policy and Process. .Educate and assist members and/or personal authorized representatives on matters associated with NaviCare insurance coverage and benefits performing a member advocacy and education role including but not limited to member rights. .Be the central communicator and care coordinator to all members of the interdisciplinary care team and keep care team members abreast on member status during their membership in the plan and also at time of care transition to ensure care team members know of the member care transition so they are able to proactively participate in member discharge planning needs. .Serves as an advocate for members to ensure they receive NaviCare benefits as appropriate and if member needs are identified but not covered by NaviCare, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other community programs.



UMass Memorial Health - Harrington

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Patient Navigator

  • Sep 2015 - Present