Care Navigator

Appalachian Regional Healthcare, Inc. • Prestonsburg, KY

1d

About The Position

The Care Navigator is responsible for coordinating access to ARH services across all areas of their healthcare
community (includes hospital, retail pharmacy, home care, home health, indigent care, etc.).

Requirements

• High school diploma required.

Nice To Haves

• Associates degree preferred.
• LPN preferred

Responsibilities

• Work collaboratively with care providers to coordinate and plan the access to care for patients across the ARH continuum;
• Work with nursing and care managers to identify ARH service opportunities (retail pharmacy, home care services, home health services, etc.) to patients being discharged;
• Make follow-up contacts to high-volume patients for local and system services;
• Provide a local resource to transition follow-up services (for example, prescription refills) through the system services (for example, the prescription mail order program);
• Promote and coordinate with home care services for post-discharge durable medical equipment and home health orders;
• Deliver completed prescriptions and supplies to patients or their caregivers;
• Assist patients in processing payment requirement;
• Assist in the completion of paperwork for medication access programs;
• Contact other resources for patient information to potentiate ARH services;
• Work with physicians and social services to obtain insurance prior authorizations for medications as needed;
• Coordinate with local service line directors to provide contiguous and coordinated services post-discharge;
• Serve as a liaison between providers and pharmacy to facilitate the prior authorization process to solve medication access and adherence issues;
• Act as a direct contact for patients to obtain assistance/updates with prior authorizations
• Initiate follow-up communications with patients and providers on the status of their medication access issues
• Performs direct entry and maintenance of patient application(s) for services;
• Responds to and provides additional information and or appeals as required by pharmaceutical companies.
• Maintains records and statistics for the purpose of evaluation and program analysis.
• Sustains general knowledge of manufacturer indigent patient program criteria and communicates changes and developments.
• Investigates and analyzes critical operational situations and provides directions for the resolution of problems.
• Performs other related duties as assigned.
• Travel as required

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees