Patient Navigator (Medical Assistant Program Completion Required)

About the role

Alignment Health is seeking a compassionate and detail-oriented patient navigator to join their Access Primary Care Physicians clinic on Smoke Ranch Road in Las Vegas, NV.

Responsibilities

• Conduct patient outreach for new, termed, and transitioned patients
• Ensure member has access to PCP and specialists to coordinate care
• Educates member on gaps in care and assist with scheduling provider appointments
• Serve as the patient's liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures
• Make patient welcome calls on date of notification of assignment and/or discharge
• Mail letters and correspondence as needed
• Make appropriate and timely patient appointments, reminders, and confirmations
• Place regular / consistent outreaches to the patient
• Communicate with PCP with any member updates and requests
• Assist with obtaining medical records from any healthcare providers involved in care or hospitals
• Help members with any authorizations and referrals involved in their care plan
• Resolve incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member’s primary care physician
• Proactively engage member with their wellness plan options

Requirements

• Medical assistant front and back office experience
• Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
• High-volume inbound customer service experience, particularly for health plan or Medicare “Member Services” roles in health plan and supplemental benefits
• Telemarketing and / or member outreach experience preferred
• Specialized experience in escalation or resolution units preferred

Qualifications

• Minimum high school diploma or equivalent
• Completion of an accredited medical assistant program

Skills and Abilities

• Independently motivated self-starter who can prioritize work assignments and make every day a productive day
• Team player willing to help and support colleagues, and do their part to support us all reaching our organizational goals
• Genuine passion for customer service
• Knowledge of ICD-10 and CPT codes
• Computer proficient, able to type minimum 35 words per minute (WPM) by 10-key touch
• Excellent written (email) and verbal (in-person and over the phone) communication skills

Supervisory Responsibilities

N/A

Pay Range

$44,987.00 - $67,480.00

Benefits

Not specified

Schedule

Monday - Friday, 7:30 AM - 4:00 PM