Patient Support Navigator

About the role

The Patient Support Navigator (PSN) is a vital part of the front-line patient and caregiver support. The PSN acts as the compass for patients throughout their journey and supports this complex process. The PSN provides patient-centered support, acts as liaison between patients, caregivers, certified treatment centers, medical professionals, and internal and external matrix partners.

Responsibilities

• Inbound Call Handling – Intermittent inbound calls throughout shift which can fluctuate with volume.
• Outbound Call Handling – Intermittent outbound calls throughout shift to patients, providers, vendors, etc.
• Data Intake – Enter patient related data by end of business shift preferably after each patient interaction.
• Processing – Process patient enrollments according to business rules of program. Targeted performance of completion within 8 hours of receipt.
• Customer Experience Score – PSNs are expected to meet and maintain a minimum call and case quality score of 90%.
• Assist patients/caregivers as appropriate within the team guidelines to function as a patient advocate, educator, and single point of contact for patients, caregivers, and certified centers.
• Field incoming phone calls from patients, caregivers, certified centers, and providers; triage calls and route to the appropriate team for further action if applicable.
• Provide scripted information on how patients can access reliable sources of information through various resources available on the team website.
• Assess patient's needs upon initial team welcome call and through navigation, matching the patient's needs with appropriate resources and support within program offerings.
• Provide newly registered patients with a welcome call including patient support materials and resources.
• Adhere to all appropriate compliance standards outlined in business rules, policies, and SOPs.
• Assess patient barriers to access such as finances, housing, food, and transportation; refer patients to aligned resources within program service offerings.
• Manage patient referral process from physician to certified treatment center through the Referral Portal/Consult Portal.
• Identify patients closest authorized treatment center and assist in scheduling consultation.
• Conduct patient follow-up calls throughout their treatment journey and post treatment while ensuring that case notes are up to date and accurate.
• Receive incoming data related to patient support programs such as enrollment forms, travel & lodging applications, copay applications, insurance cards for benefits investigations for review, save related documents within the patient database, triage, and route data to the appropriate department or team member as applicable.
• Conduct benefit investigation and prior authorization with payers.
• Provide strategic communication and timely updates while partnering with all team members to ensure patients are served in an appropriate manner.
• Serve as a primary point of contact for all treatment centers and team members within your designated region(s).
• Participate and support multiple ongoing department projects.
• Ensure patient centered excellence in supporting all internal and external stakeholders involved in the patient journey.
• Other tasks and projects as assigned including but not limited to client inquiries, exceptions, management mailbox, reconciliation reports, and workforce functions.
• All other duties as assigned.

Expectations of the job

• Learn, understand, and follow all company and client policies and procedures.
• Accept being accountable and responsible in work practices and expectations. Delivers what is promised.
• Foster a collaborative, team-oriented attitude. Communicates effectively with others with clarity and transparency.
• Use innovative critical and creative thinking to evaluate and solve work and customer issues.
• Seek assistance in solving work problems through collaboration and information seeking.
• Personal Accountability
• Attendance – Excellent attendance is a key success driver for this role
• Compliance Wire Online Training – at least 95% on-time completion
• Professional, positive, ethical, and responsible behavior
• Collaboration, proactive, and effective communication
• Ability to self-manage, multitask and problem solve
• Proficient computer skills
• Demonstrate cultural beliefs
• Agents who regularly perform at or above the targeted performance levels will be eligible for remote work opportunities with the following considerations:
  • Supervisor approval
  • Proof of HIPAA compliant workspace
  • Proof of secure internet connectivity with sufficient bandwidth to successfully conduct the role activities
  • Maintain in office performance & quality levels and schedule adherence

Qualifications

Education: Bachelor's Degree and/or 5 years' experience in healthcare practice management or patient services setting.

Technology/Equipment: Strong computer skills with a working knowledge of Microsoft Word, Excel, and PowerPoint. Ability to learn other systems as needed.

Soft Skills: Excellent oral, written, and interpersonal communication skills. Ability to multi-task. Ability to work independently, have personal accountability, function as a team player, and to collaborate with others. Ability to work in a fast paced, metric driven environment, while remaining patient minded. Strong customer service skills. Ability to adapt to EVERSANA's cultural beliefs.

Preferred qualifications

• Patient support and access with call center experience.
• Patient assistance, reimbursement and/or oncology experience.
• Medical coding, insurance coverage, policy, and payment experience strongly preferred.

Physical and mental demands

While performing the essential functions of this job the employee is frequently required to reach, grasp, stand and/or sit for long periods of time (up to 90% of the shift), walk, talk and hear; occasionally required to lift and/or move up to 25 pounds. This job operates in a professional office and/or remote work environment. This role routinely uses standard office equipment. The noise level in the work environment is usually moderately quiet, with frequent interruptions and multiple demands. This role requires mental alertness. The employee must regularly communicate both verbally and written; concentrate on tasks; and remember and observe details. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.