Health Navigator - 25-231

PriMed Management Consulting•San Ramon, CA

14d•$28 - $32

About The Position

The Health Navigator acts as the primary advocate for high-risk patients by helping them understand and navigate the complex managed care system. The purpose of the Health Navigator role is to improve patient health outcomes and increase compliance on quality metrics by educating and connecting the patient to an interdisciplinary care team, collect relevant patient information, provide linkages to necessary resources and non-clinical services.

Requirements

2 plus years’ experience in the health care delivery system with special emphasis at a provider office
Background understanding general medical terminology and/or certification of medical coding practices
Superior telephone customer service skills with ability to build trust and relationship with patient telephonically
Demonstrated case ownership with ability to manage a range of priorities and meet specific deliverables
Intellectual curiosity and willing problem solver
Proficient skill level and experience with MS Office applications
High School Diploma/GED required or college degree highly preferred

Responsibilities

Maintains strong working knowledge of managed care and healthcare systems
Independently evaluates individual patient needs and connects patient to available internal and external resources of the medical group in order to improve quality compliance and reduce patient disease burden
Address and stress with the patient the importance of clinical preventive screenings such as, but not limited to Colorectal, Breast, Cervical Cancer Screenings, Diabetes Care, Medication Adherence, Osteoporosis Screening and Medication Reconciliations.
Build and maintain meaningful relationships with patients to facilitate care management by being a patient advocate
Use and manage technology platforms to help identify at risk patient populations and to implement targeted interventions (e.g. HillMetrics, EPIC CareEverywhere, EPIC Tapestry, IVR platform)
Under the guidance of the Supervisor and approved protocols the Health Navigator will direct patient to appropriate nurse case manager, clinical pharmacist, health educator and social worker depending on the unique needs of the patient
Reviews pertinent health information with patient including post-discharge instructions, urgent care options, medical and pharmacy benefits and physician provider networks
Assists patients with scheduling medical appointments and non-emergency medical transportation
Ensures regular and consistent communications with patients by providing timely follow-up to ensure resolution of issues
Participate in interdisciplinary clinical teams with nurse case managers, social workers, pharmacists, physicians and health educators in discussing patient cases in order to improve patient outcomes
Provides clear documentation of all patient encounters meeting state and federal regulatory requirements
Accurately captures patient’s general health status and information
Administer non-clinical patient assessments
All other duties as assigned