Patient Navigator is the patient's program liaison. Primarily telephonic, this role is responsible for ensuring that the patient experiences a smooth transition, from an admission or outpatient procedure, back to the home setting. Throughout the duration services, this role will uncover and act on possible barriers to a healthy outcome, thereby safeguarding against unnecessary readmissions.
Address program specific quality measures and adhere to company guidelines/standard operating procedures during the life cycle of the patient.
Make all patient welcome calls on date of notification of assignment and/or discharge. Make appropriate and timely patient appointments, confirmations, and appointment reminders. Mail letters as needed.
Complete telephonic inpatient visits with patients utilizing current standard operating procedures.
Notify all appropriate departments (PTID) of data related patient case updates.
Outreach to patients providers and input appointments.
Place regular/consistent outreaches to the patient.
Adhere to established guidelines for case closings.
Provide support to patients either prior to admission for an elective procedure, post-discharg from the hospital, or post-procedure.
Identify and connect patient to resources for addressing Social Determinants of Health (SDOH).
Outreach to the appropriate party to report any benefit, authorization, claim or eligibility related issue.
Conduct home visits or errands with or on behalf of the patient.
Prepare information for patient case status summaries, success stories, etc. and participate in daily huddles,weekly meetings, and other scheduled events, both internally, and with clients externally. Take initiative to proactively resolve and or support tough patient cases via communication to management and or clients during weekly meetings.
Take initiative to proactively resolve barriers and or support high acuity patient cases via communication to management and or appropriate party during weekly meetings and escalations.
Prepare, communicate, and follow through on patient flagpole/escalation communications to management.
Conduct and collaborate on creating an action plans for patient readmission.
Review system related tasks and email instructions throughout the day for management of daily responsibilities in order to effectively and thoroughly manage all assigned patient cases to completion.
Maintain patient outreach and daily activities for cases assigned to out of office Patient Navigators and peers as directed by leadership team.
Document accurately all phone calls, interventions, appointments and other system related data points in PILOT system within 24 hours.
Utilize all internal database alerts and daily/weekly reports to effectively and thoroughly manage all assigned patient cases to completion.
Other duties as assigned by leadership may exist to meet business needs.
High school graduate or equivalent.
Minimum 2 years of strong customer service and/or healthcare experience in a fast-paced environment.
Strong working knowledge of medical terminology and healthcare landscape
Excellent written and verbal communication skills
Able to act independently with minimum supervision
Proficiency in MS Office Outlook and Word
Excellent problem solving, critical thinking, and organizational skills
Basic computer skills to include typing, data entry, internet research, and spelling accuracy
Healthcare experience is preferred but not required
Preferred reliable transportation to get to work and to travel to and from hospitals, patient residences, mutual locations, etc. on occasion as needed.
If driving is required in this job role:
Must possess a valid State driver's license, current vehicle registration and insurance
Vehicle must be reliable and in good working order
Hands free technology devices are required when driving
Work Conditions and Physical Requirements
The working conditions characteristics and physical requirements described here are representative of what one may encounter while performing the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to perform the job duties in an office setting autonomously with minimal supervision.
Office settings require frequent sitting, standing, walking, bending and stooping. Physical requirements may include occasional lifting not to exceed 25 lbs.
Health is improving the healthcare experience for seniors to live more fulfilling lives. For nearly a decade, navi
Health has been a trusted partner for the nation's top health plans, health systems, and at-risk physician groups navigating the shift from volume to value. Powered by a predictive technology and decision support platform that provides clinicians and care teams with evidence-based protocols, navi
Health's high-touch, proven care model fully supports patients from pre-acute through to the home. With navi
Health, patients can enjoy more days at home, and healthcare providers and health plans can significantly reduce costs specific to unnecessary care and readmissions. For more information about navi
Health, visit www.navihealth.com.
Improving the healthcare experience for seniors to live a more fulfilling life
Rooted in respect
Guided by purpose
Devoted to service
Energized by impact
The above statements are intended to describe the general nature and level of work performed by colleagues assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications. navi
Health reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other protected status under applicable laws and will not be discriminated against on the basis of disability.