RPM Patient Navigator

About the Role

The Patient Navigator will be responsible for patient/member outreach activities related to managing chronic conditions, mainly hypertension and diabetes. This role provides direct support to patients in a 1:1 setting to ensure they feel confident utilizing remote monitoring devices and understand how these tools will aid their health. The Patient Navigator guides patients through their treatment journey, supports the Senior Program Director, and leads the remote patient monitoring program.

Responsibilities

• Welcome patients into continuous care program(s) and review benefits and services included.
• Educate patients on the frequency and use of their assigned in-home monitoring devices.
• Conduct patient outreach calls or messages to troubleshoot equipment, encourage daily compliance, and provide basic health education.
• Interpret and comply with quality assurance standards and industry regulatory and quality requirements.
• Document and report product or service quality levels.
• Complete health risk assessments as necessary.
• Monitor payer data reporting requirements and upload data to payer portals.
• Present and monitor program performance, including enrollments, activity, and compliance.
• Meet program deliverables and organizational goals, including grant deliverables.
• Monitor all payer portals and respond to insurance-driven requests for data, collaborating with the QAQI team as needed.
• Conduct random chart audits for the clinical team.
• Perform data entry, answer, refer, and/or follow up via telephone, fax, email, and mail regarding patient questions related to the program.
• Triage patient needs to the appropriate care team.
• Maintain accurate documentation in Google Sheets or tracking logs.
• Perform routine specialized procedures, such as setting up iHealth products for patients under established protocols.
• Manage clinic inventories and medical supplies.
• Educate and advise patients on specific medical issues within established parameters, including obtaining prescription information.
• Direct patient flow following provider schedules and patient appointments.
• Coordinate routine office activities and administrative functions to support clinic operations.
• Other duties as assigned by the Senior Program Director.

Requirements

• College degree preferred, but not required if candidate has relevant work experience.
• Previous experience in member services or community outreach; knowledge of regulatory requirements.
• Good verbal communication skills, including the ability to effectively communicate with internal and external customers.
• Experience implementing corrective action programs.
• Experience with eCW preferred, but not required.
• Proficiency with databases and Microsoft Office or Google Suite.
• Knowledge of QA terms, tools, and methodologies.
• Bilingual (English/Spanish) is required.

Skills

• Working knowledge of HRSA, FTCA, and FQHC-specific compliance requirements.
• Strong communication and facilitation skills across multidisciplinary teams.
• Ability to analyze data, identify trends, and implement solutions.

Physical Requirements

• Occasional light lifting up to 25 pounds, bending, stooping, or squatting.
• Considerable walking and ability to sit or stand for extended periods.
• Flexibility to work in multiple locations throughout the week.
• Finger dexterity and hand coordination required.
• Specific vision abilities: close vision, distance vision, and ability to adjust or focus.

Work Environment

• Exposure to adverse conditions, including extreme heat, cold, wet/humid conditions, and outside weather.
• Exposure to moving mechanical parts, fumes, airborne particles, toxic or caustic chemicals, and possible risk of electrical shock, radiation, or vibration.
• Exposure to high, precarious places and explosives.
• Protective clothing or equipment may be required, including gloves, helmets, steel-toed boots, and protective eyewear.
• High noise levels in the work environment.