Patient Care Navigator

VALLEY-WIDE HEALTH SYSTEMS INC•San Luis, CO

5d•$20 - $25•Onsite

About The Position

Valley-Wide Health Systems, Inc. is seeking a Patient Care Navigator to join their team. This role is crucial in assisting patients with navigating the healthcare system, overcoming financial and social barriers, and ultimately improving their health outcomes. The position is designed to foster a culture of patient-centered care, enhance patient experiences, improve operational efficiency, and promote excellence in quality and safety within the organization.

Requirements

High school diploma required
1+ year of experience in customer service, support, coordination, or case management.
Strong customer service and interpersonal communication skills.
Excellent critical thinking, organizational, and problem-solving abilities.
Ability to prioritize multiple tasks and work effectively in a fast-paced healthcare environment.
Proficiency in Microsoft Word, Excel, Outlook, and Electronic Health Record (EHR) systems.
Ability to communicate professionally in person, over the phone, and through electronic communication.
Ability to collaborate effectively with providers, nursing staff, and interdisciplinary healthcare teams.
Sensitivity to the needs of low-income, underserved, and diverse populations.

Nice To Haves

Bachelor’s degree in Business, Healthcare Administration, Human Services, Social Work, or a related field preferred
Knowledge of referral management, appointment scheduling, and insurance authorization processes preferred.
Familiarity with community resources and patient assistance programs.
Bilingual Spanish-speaking preferred but not required.

Responsibilities

Facilitates patient access to care by assisting with healthcare navigation, addressing barriers to care, and coordinating communication between patients and the healthcare team.
Assist patients in resolving issues related to healthcare access, financial barriers, and social needs.
Respond to patient inquiries via phone, patient portal, and in person, ensuring timely, professional, and compassionate communication.
Help patients complete enrollment applications for programs such as Senior Dental, Medicaid, Sliding Fee Discount Program, and MedRide.
Request interpreters, transportation services, prescription assistance, and other supportive services as needed.
Verify and collect documentation to support eligibility for state and local assistance programs.
Coordinate with nursing and clinical staff to address urgent patient concerns and ensure appropriate follow-up.
Facilitate follow-up appointments before patients leave the clinic whenever possible.
Maintain confidentiality of all patient information in accordance with HIPAA and organizational policies.
Supports patients throughout their healthcare journey by coordinating referrals, authorizations, appointments, and ongoing care needs.
Conduct comprehensive assessments for new and referred patients, evaluating clinical and psychosocial needs.
Guide patients in understanding healthcare recommendations, treatment plans, available services, and medical benefits.
Coordinate specialty referrals, imaging, diagnostic testing, and follow-up appointments.
Process, monitor, and document prior authorizations for specialty care, imaging, medications, and diagnostic procedures.
Follow up on pending or denied authorizations and assist with appeals as appropriate.
Manage incoming referrals and communicate with patients, providers, and outside facilities to ensure continuity of care.
Assist patients in establishing a Primary Care Provider within the Patient-Centered Medical Home model.
Coordinate communication with insurance providers, specialty offices, and community resources to facilitate timely patient care.
Collaborates with interdisciplinary teams while maintaining accurate documentation and supporting clinic operations.
Participate in daily team huddles and collaborate with providers, nursing staff, care teams, and support personnel.
Document patient interactions, referrals, authorizations, social determinants of health screenings, and case management activities within the Electronic Health Record (EHR).
Manage patient portal requests, telephone encounters, and provider communications in a timely manner.
Assist in running reports and supporting quality improvement initiatives by scheduling preventive and routine healthcare services.
Maintain accurate records for audits, referrals, and authorization tracking.
Provide additional clinic support as needed to promote efficient workflow and exceptional patient care.
Perform other duties as assigned.