Patient Navigator-Pediatric Neurosurgery

WVU Medicine

About The Position

The Patient Navigator is a member of a multidisciplinary team and is responsible and accountable for managing patients through the healthcare system. The position serves as a primary point of contact for patients, helps remove barriers to care, coordinates services and appointments, supports insurance and prescription processes, and connects patients with clinical, social, emotional, and financial resources.

Requirements

Bachelor’s degree in Healthcare Management, Public Health, or another related field; or an associate’s degree in one of these or another related field plus two years of experience directly related to the duties and responsibilities; or a high school diploma or equivalent plus four years of directly related experience.
Excellent interpersonal communication and negotiation skills when interacting with patients, families, providers, and healthcare team colleagues.
Ability to work with people from all social, economic, and cultural backgrounds and to be flexible, open-minded, and adaptable to change.
Proficiency in Microsoft Office.
Ability to sit for extended periods.

Nice To Haves

Bachelor’s degree in Healthcare Management or Public Health.
Three years of experience in the healthcare field.
One year of experience in statistical data analysis.

Responsibilities

Establish close relationships with patients and serve as their primary point of contact.
Collect and analyze market data to identify payor populations based on regional payer mix; verify insurance benefits and coverage for obesity treatment.
Maintain knowledge of insurance payor pre-certification requirements for medications, diagnostic testing, surgery, referrals, and related services, and proactively review policy changes to prevent delays where applicable.
Educate providers and staff about payor regulations to help prevent denials.
Identify resources that remove barriers to care and help patients navigate healthcare services.
Coordinate appointments across service lines where applicable.
Schedule and adjust patient appointments, including coordination with laboratory or diagnostic testing, appointment adherence, reminder calls, and management of the patient wait-list.
Monitor assigned patients’ admissions, round on them daily, and assist with scheduling discharge appointments.
Assist patients in filling prescriptions and assess cost and availability.
Document patient information and obtain outside records as needed.
Engage family and community resources to address patients’ identified emotional, social, and financial needs.
Collaborate with social services on resource and financial management, including financial assistance and entitlement program referrals, patient benefit coordination, appropriate use of healthcare resources, and clinical cost efficiency.
Perform other department-specific duties as assigned.