Patient Navigator (Medical Assistant Program Completion Required)

Alignment Health•Las Vegas, NV

58d•$44,987 - $67,480•Onsite

About The Position

Alignment Health is seeking a compassionate and detail oriented patient navigator to join their Access Primary Care Physicians clinic on Smoke Ranch Road in Las Vegas, NV. As a patient navigator, you will provide outreach and support to ensure all our members have access to the care they deserve. You will navigate our members through their health care and benefits, and connect the dots between our provider network, health plan operations, and supplemental vendors. You will be alongside our members every step of the way to ensure they are never alone in their healthcare journey and have the highest level of coordinated care. Patient navigators are active members of the health care team, addressing immediate needs and laying the groundwork for future and ongoing member support. This is a role for a passionate and experienced healthcare professional who understands the meaningful contribution they make to our members’ healthcare outcomes. Individuals with front and back office medical assistant experience and care coordination experience highly encouraged to apply!

Requirements

Medical assistant front and back office experience.
Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
High-volume inbound customer service experience, particularly for health plan or Medicare “Member Services” roles in health plan and supplemental benefits preferred
Telemarketing and / or member outreach experience preferred
Specialized experience in escalation or resolution units preferred
High school diploma or general education degree (GED).
Completion of an accredited medical assistant program.
Independently motivated self-starter who can prioritize work assignments and make every day a productive day
Team player willing to help and support colleagues, and do their part to support us all reaching our organizational goals
Natural “teacher” with the ability to learn plans and describe / explain / educate healthcare coverage and services to our members
Genuine passion for customer service
Knowledge of ICD-10 and CPT codes.
Computer proficient, able to type minimum 35 words per minute (WPM) by 10-key touch.
Excellent written (email) and verbal (in-person and over the phone) communication skills.
Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
Able to write routine reports and correspondence.
Able to speak effectively before groups of customers or employees of the organization.
Able to apply common sense understanding to carry out detailed but uninvolved written or verbal instructions.
Able to deal with problems involving a few concrete variables in standardized situations.
Strong computer skills.

Nice To Haves

Bilingual written and verbal fluency in English and Spanish, Korean, or Vietnamese.

Responsibilities

Conduct patient outreach for new, termed, and transitioned patients
Ensure member has access to PCP and specialists to coordinate care
Educates member on gaps in care and assist with scheduling provider appointments
Serve as the patient's liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures
Make patient welcome calls on date of notification of assignment and/or discharge
Mail letters and correspondence as needed
Make appropriate and timely patient appointments, reminders, and confirmations
Place regular / consistent outreaches to the patient
Prepare, communicate, and follow through on patient flagpole/escalation communications to management
Communicate with PCP with any member updates and requests
Assist with obtaining medical records from any healthcare providers involved in care or hospitals
Help members with any authorizations and referrals involved in their care plan
Resolve incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member’s primary care physician and proactively engage member with their wellness plan options.