Transition of Care (TOC) Health Navigator

About the role

The Transition of Care (TOC) Health Navigator is primarily responsible for providing outreach efforts to a group of patients from a shared patient list in the hospital inpatient and/or Emergency Department (ED), and other UCDH Care settings. This task-oriented role will utilize the established model of care and serve as a non-clinical resource and liaison for patients, their families, and providers for all post-hospitalization patient needs within 30 days, or more if needed, of discharge.

Responsibilities

• Intake and Scheduling Functions
• Documentation
• Insurance Verification/Authorizations
• Communication and Collaboration
• Education and Professional Development

Requirements

• High school diploma, GED, or equivalent experience/training.
• Experience working within a complex health system environment.
• Knowledge of all payer systems, procedures and regulations including Medicare, MediCal, Managed Care and Third Party and experience obtaining authorizations.
• Knowledge of use and proficiency with computers, including mainframe applications such as WEB based search engines, and other software programs, including Microsoft Office Suite.
• Competent decision making and problem-solving abilities and adept at initiating actions and effective resolution and follow through to ensure appropriate utilization of clinical resources for patient care, completion of department activities/projects, demonstrating good judgment and common sense; analytical skills to review all available information, draw conclusions, develop and evaluate alternatives, develop solutions, and monitor processes.
• Physical and emotional stamina to regularly work within tight frames and critical deadlines, deal with upset, irate or hostile members of the public, handle sensitive and confidential information, and perform tasks requiring long periods of concentration.
• Able to communicate effectively both orally and in writing in an informative and diplomatic manner with referring/network physicians, hospital administration, faculty, staff, patients, and general public; knowledge and ability to utilize effective listening and questioning techniques, and proof-reading skills.
• Ability to exercise initiative, originality, and judgment in applying established principles and practices to unique and complex problems that involve multiple variables.
• Ability to multitask and set priorities, organize work independently, set up and maintain manual tracking systems for authorizations, follow-up, preliminary referrals, etc.
• Ability to works effectively in an area with constant interruptions and traffic, including noise from telephones, staff conversations, and office equipment.
• Ability to work independently in a fast paced, demanding environment with minimal supervision.
• Ability to manage and oversee multiple tasks simultaneously, including high daily call volume.
• Ability to recognize and maintain confidentiality of patient information and comply with all HIPAA laws.
• Strong communication and interpersonal relationship skills to establish and maintain effective relationships with patients, families, team members, hospital staff in a wide variety of positions and departments; ability to be sensitive and effective with persons representing a broad spectrum of social, ethnic and economic backgrounds.
• Ability to read, write, speak and understand English language and to utilize Medical Interpretation Services.
• Good organizational skills, ability to independently coordinate a variety of tasks and functions, ability to set priorities, and recognize situations requiring clinical intervention, ability to be flexible and responsive.
• Able to remain calm, professional focused and works effectively in a fast-paced work environment.

Qualifications

• High school diploma, GED, or equivalent experience/training.
• Experience working within a complex health system environment.
• Knowledge of all payer systems, procedures and regulations including Medicare, MediCal, Managed Care and Third Party and experience obtaining authorizations.
• Knowledge of use and proficiency with computers, including mainframe applications such as WEB based search engines, and other software programs, including Microsoft Office Suite.
• Competent decision making and problem-solving abilities and adept at initiating actions and effective resolution and follow through to ensure appropriate utilization of clinical resources for patient care, completion of department activities/projects, demonstrating good judgment and common sense; analytical skills to review all available information, draw conclusions, develop and evaluate alternatives, develop solutions, and monitor processes.
• Physical and emotional stamina to regularly work within tight frames and critical deadlines, deal with upset, irate or hostile members of the public, handle sensitive and confidential information, and perform tasks requiring long periods of concentration.
• Able to communicate effectively both orally and in writing in an informative and diplomatic manner with referring/network physicians, hospital administration, faculty, staff, patients, and general public; knowledge and ability to utilize effective listening and questioning techniques, and proof-reading skills.
• Ability to exercise initiative, originality, and judgment in applying established principles and practices to unique and complex problems that involve multiple variables.
• Ability to multitask and set priorities, organize work independently, set up and maintain manual tracking systems for authorizations, follow-up, preliminary referrals, etc.
• Ability to works effectively in an area with constant interruptions and traffic, including noise from telephones, staff conversations, and office equipment.
• Ability to work independently in a fast paced, demanding environment with minimal supervision.
• Ability to manage and oversee multiple tasks simultaneously, including high daily call volume.
• Ability to recognize and maintain confidentiality of patient information and comply with all HIPAA laws.
• Strong communication and interpersonal relationship skills to establish and maintain effective relationships with patients, families, team members, hospital staff in a wide variety of positions and departments; ability to be sensitive and effective with persons representing a broad spectrum of social, ethnic and economic backgrounds.
• Ability to read, write, speak and understand English language and to utilize Medical Interpretation Services.
• Good organizational skills, ability to independently coordinate a variety of tasks and functions, ability to set priorities, and recognize situations requiring clinical intervention, ability to be flexible and responsive.
• Able to remain calm, professional focused and works effectively in a fast-paced work environment.

Skills

• Excellent communication skills.
• Problem-solving abilities.
• Initiative and originality.
• Ability to multitask and set priorities.
• Organizational skills.
• Customer service skills.
• Interpersonal relationship skills.
• Effective listening and questioning techniques.
• Proof-reading skills.

Benefits

• High quality and low-cost medical plans to choose from to fit your family's needs.
• UC pays for Dental and Vision insurance premiums for you and your family.
• Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave.
• Paid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement.
• Paid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement.
• Continuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement.
• Access to free professional development courses and learning opportunities for personal and professional growth.
• WorkLife and Wellness programs and resources.
• On-site Employee Assistance Program including access to free mental health services.
• Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage.
• Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles.
• Retailment benefit options for eligible roles including Pension and other Retirement Saving Plans.

Pay

Salary or Pay Range: $26.72 - $41.30
Salary Frequency: Hourly
Salary Grade: 141
UC Job Title: PAT NAVGTR NON-CLIN 2 CX
UC Job Code: 004468
Number of Positions: 1
Appointment Type: Career
Percentage of Time: 80% Part-time
Shift (Work Schedule): Four consecutive 8-hour shifts (8:00 AM–4:30 PM) with a rotating schedule that may include Monday–Thursday, Tuesday–Friday, and occasional weekend coverage based on operational needs.
Location: North Addition Office Building, Sacramento, CA
Union Representation: CX-Clerical/Admin
Benefits Eligible: Yes

Schedule

Hours are variable and work dependent but will include coverage on weekends and holidays.