Patient Care Navigator, Rehabilitation Services

Integrated Pain Management Medical Group, Inc.•Los Gatos, CA

10h•$23 - $30

About The Position

The Patient Care Navigator serves as a dedicated advocate and central coordinator for individuals receiving care through Boomerang’s Rehabilitation Services programs. This role ensures that each person served experiences a seamless, dignified, and individualized care journey—from initial referral and pre-admission evaluation through active program participation and successful community transition. The Navigator facilitates communication among the interdisciplinary care team, payers, and the person served, upholding the organization’s commitment to person-centered, evidence-based, and outcomes-driven rehabilitation care in alignment with Joint Commission and CARF accreditation standards

Requirements

High School Diploma or equivalent required; Associate’s or Bachelor’s degree in health sciences, social work, or a related field preferred.
Minimum 1–2 years of experience in a healthcare, rehabilitation, or behavioral health setting preferred.
Previous experience with electronic medical record (EMR/EHR) systems strongly preferred.
Demonstrated commitment to person-centered care, patient rights, and trauma-informed communication.
Ability to identify and resolve problems in a timely manner; skilled in gathering and analyzing information and developing alternative solutions.
Proficiency in Microsoft Office Suite, particularly Excel; ability to learn organization-specific software systems.
Strong written and verbal communication skills; ability to translate complex clinical and insurance information for persons served and families.
Knowledge of workers’ compensation regulations, insurance authorization processes, and/or healthcare billing preferred.

Responsibilities

Serve as the primary point of contact and advocate for persons served throughout all phases of rehabilitation, including pre-admission, active program participation, and transition/discharge planning.
Communicate authorization decisions, program updates, and care plan changes to persons served, families/support systems, referring physicians, nurse case managers, and legal representatives in a timely, respectful, and culturally sensitive manner.
Coordinate individualized scheduling and logistics—including transportation and lodging resources—to reduce barriers to participation and support the person’s goals and preferences.
Identify and proactively address daily barriers to program participation (e.g., transportation issues, interpreter needs, absence management) in a manner that respects each person’s rights and dignity.
Manage and maintain the authorization module for multidisciplinary evaluations and rehabilitation programs, ensuring accuracy and timeliness in accordance with contractual agreements and applicable workers’ compensation regulations.
Process referrals, submit Requests for Authorization (RFAs), coordinate peer-to-peer reviews and appeals, and issue internal authorizations to site-based navigators within required timeframes.
Collaborate with billing to verify that pre-claim requirements are fulfilled and that the person’s coverage and benefits align with recommended services prior to admission.
Maintain census data and track each person’s progress through the program continuum, ensuring timely updates to all relevant stakeholders.
Prepare, facilitate, and document weekly interdisciplinary team conferences consistent with CARF and Joint Commission standards for coordinated care planning, ensuring the voice and goals of the person served are central to team discussions.
Coordinate arrangements for external consultants, telehealth/video appointments, and conference calls as needed to support comprehensive care delivery.
Compile, enter, and distribute evaluation summaries, weekly program status reports, and discharge summaries from providers in the electronic medical record (IMS/EHR) and to authorized parties.
Administer validated psychological screening and assessment tools to persons served at designated intervals (pre-program, mid-program, and post-program) in accordance with established protocols and standards of care.
Ensure documentation is complete, timely, accurate, and compliant with Joint Commission record-keeping requirements and CARF standards for program data integrity.
Maintain required program tracking logs, authorization records, and outcome data to support quality improvement and accreditation reporting.
Communicate with persons served, families, visitors, and interdisciplinary team members in a courteous, respectful, trauma-informed, and professional manner that upholds patient rights and organizational values.
Create and distribute virtual class links and onboarding resources to persons served and providers to support engagement and access to program materials.
Act as a liaison and resource for prospective persons served, care teams, and community partners regarding program offerings, eligibility, and the referral process.
Maintain adequate inventory levels of evaluation and program materials; submit purchase requests to the Program Director as needed.
Process and submit invoices promptly upon receipt to the accounting department and track program expenses using the organization’s expense management system (Emburse).
Ensure the program environment is clean, organized, and welcoming to persons served, reflecting a culture of safety and respect.
Create weekly scheduling templates in the EHR/IMS and coordinate scheduling resources across all program sites.
A solid understanding of the workers’ compensation system (training provided) is essential to effectively guide patients through the process and support them throughout their recovery journey. This role may involve providing education and assistance in both individual and group settings.
Assumes other responsibilities as appropriate to the position and organizational needs