Patient Navigator (Reynold's Memorial Hospital)

We’re looking for a Patient Navigator to join a multi-disciplinary team and manage patients through the healthcare system.

Qualifications

Minimum Qualifications

• Bachelor’s degree in Healthcare Management, Public Health, or other related field OR
• Associate’s degree in Healthcare Management, Public Health or other related field AND two (2) years of experience directly related to the duties and responsibilities specified OR
• High school diploma or equivalent AND four (4) years of experience directly related to the duties and responsibilities specified.

Preferred Qualifications

• Bachelor’s degree in Healthcare Management or Public Health.
• Three (3) years’ experience in the healthcare field.
• One (1) year of experience in statistical data analysis.

Responsibilities

• Establishes close relationships with and serves as primary point of contact for patients.
• Strategizes to help find payor population based on regional payer mix by collecting and analyzing market data.
• Responsible for verifying insurance benefits and ensuring coverage for obesity treatment for patients.
• Maintains a working knowledge of insurance payors pre-certification requirements for medications, diagnostic testing, surgery, referrals, etc.
• Proactively reviews policies for changes to prevent delays in certification where applicable.
• Educates providers and staff on payor regulations in order to prevent denials.
• Removes barriers to care by identifying resources for patients and helping them navigate through healthcare services.
• Works with different service lines to assure coordination of appointments if applicable.
• Schedules patient appointments and adjusts as needed, including coordinating appointments with laboratory or diagnostic testing, ensuring adherence to appointments, reminder calls, and managing the patient wait-list.
• Monitors assigned patients for hospital admission and rounds on them daily; assists with scheduling discharge appointments.
• Assists with getting prescriptions filled, assessing cost and availability.
• Documents patient information and obtains outside records, as needed.
• Engages family and/or community resources to meet the identified emotional, social, and financial needs of the patient.
• Collaborates with available social services for appropriate resource and financial management, including financial assistance coordination and referrals, entitlement program coordination and referrals, patient benefit coordination, assessment for appropriate usage of healthcare resources, and clinical cost efficiency.
• Performs other department-specific duties as assigned.

Skills

• Excellent interpersonal communication and negotiation skills in interactions with patients, families, providers, and healthcare team colleagues.
• Ability to work with people of all social, economic, and cultural backgrounds; flexible, open-minded, and adaptable to change.
• Proficient in Microsoft Office.

Physical Requirements

• Ability to sit for extended periods of time.

Working Environment

Standard office/clinical environment.

Schedule

40 hours per week, non-exempt shift.