Patient Advocate / Social Worker

Proactive MD•Franklin, WI

1d•Onsite

About The Position

Proactive MD offers a comprehensive health management solution focused on employee health, providing on-site physicians, direct primary care services, and client support. The company aims to deliver better outcomes, making people healthier and more productive while lowering medical costs for employers. The mission of the Patient Advocate (PaD) is to facilitate and ensure continuity in patient care, serving as a bridge between health center services and the community. The PaD will strategically engage employees and their dependents before, during, and after visits to the center to ensure personalized, informative, and compassionate care. This role is supported by and reports to the Director of Patient Care Navigation and involves close collaboration with the Client Relations, Clinical Operations team, Health Center Provider, and Client HR Team.

Requirements

2+ years of experience working in healthcare setting, Medical or Healthcare Social Work in similar setting, or Case Management role
Bachelor of Social Work Degree
Current BLS certification through American Heart Association valid for at least 90 days after start date
Medical terminology, including understanding of specialists
Knowledge of the concepts and principles of medical case management
Ability to communicate effectively and maintain working relationships with people from diverse backgrounds
Knowledge of the healthcare industry and available patient resources
Knowledge of payors
Ability to prioritize needs and plan work accordingly
Knowledge of HIPAA confidentiality requirements

Nice To Haves

Master’s degree in Social Work
Knowledge of third-party payer requirements
Licensure in LPCW, LCIS, LPC or similar

Responsibilities

Coordinate care with external specialists, imaging centers, labs, medical equipment providers, counselors, community resources, etc. under the direction of the Provider.
Ensure electronic medical records are provided to Proactive MD’s Provider following any specialist visit and that Provider records are sent to specialists prior to patient visit.
Receive prior authorizations required by the insurance company for tests or procedures and, as appropriate to the Health Center, send prior notification to insurance regarding procedures or referrals.
Continuously refine and update list of value-based providers suitable for referral in the community the Health Center serves.
Assist patients in navigating the healthcare system.
Coordinate care when a patient is admitted and discharged from the emergency room or hospital. Ensure Proactive MD’s Provider is included in the aftercare process.
Visit hospitalized patients to ensure care coordination is directed by the Provider.
Coordinate with "Care Beyond the Walls RN Case Manager" with medically complex patients requiring significant out of Health Center care.
Engage with patients to encourage use of the Health Center (high risk dashboard or patient engagement dashboard).
Encourage and coordinate follow-up visits at the Health Center.
Work in coordination with the on-site Provider, Client Relations and Client representative to develop outreach campaigns and educational resources. The PaD is responsible for the execution and success of these campaigns.
Represent the Health Center at internal and external meetings and events.
Encourage completion of patient survey at end of each Health Center encounter.
Text/email/mail patient communications regarding significant events (birthdays, get well, condolences, congratulations, etc.).
Be knowledgeable about and provide information to patients regarding available community services that could enhance their care.
Coordinate patient care and treatment plans; provide educational materials/consultation; follow up on patient well-being.
Assist patients using individual appointments in understanding benefits available to them through their health insurance program (EAP etc.).
Coordinate with Clinical Operations in times of high Health Center utilization to ensure that patients are greeted, checked in, and roomed, and phones are answered.
Engage with provider in role of “embedded” case manager for optimal utilization of skills and abilities.
Encourage patient completion of tablet based patient satisfaction survey.
Participate in any Health Center wide meetings to ensure excellent cross communication and collaboration.