Uniontown Primary Care Clinics-Patient Navigator

WVU Medicine

11d•Onsite

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 role serves as a primary point of contact for patients, helps them navigate services and overcome barriers to care, coordinates appointments and follow-up, and supports insurance authorization and coverage needs. The Patient Navigator also collaborates with providers, clinic staff, service lines, social services, and health service coordinators to support patient care, quality benchmarks, education, and research efforts. The position may include in-office testing and travel to WVU Medicine Uniontown Primary Care Clinics.

Requirements

Bachelor’s degree in Healthcare Management, Public Health, or a related field; or an associate’s degree in one of these fields plus two years of experience directly related to the duties; 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 different 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.
Ability to travel to WVU Medicine Uniontown Primary Care Clinics.

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 payer populations based on regional payer mix; verify insurance benefits and coverage for obesity treatment.
Maintain working knowledge of insurer pre-certification requirements for medications, diagnostic testing, surgery, referrals, and related services; review policy changes to prevent certification delays.
Educate providers and staff about payer regulations to help prevent denials.
Identify resources and remove barriers to care, helping patients navigate healthcare services.
Coordinate appointments across service lines where applicable.
Schedule and adjust appointments, including coordinating laboratory and diagnostic testing, supporting appointment adherence, making reminder calls, and managing the patient wait-list.
Monitor assigned patients' admissions, round on them daily, and assist with scheduling discharge appointments.
Help patients fill prescriptions by assessing cost and availability.
Document patient information and obtain outside records as needed.
Engage family and community resources to address patients' 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.
Schedule patients for Annual Wellness Visits, run quality reports for providers, and collaborate with clinic staff, physicians, and advanced practice providers to improve quality benchmarks.
Collaborate on outreach and assist in managing patients with complex and comorbid conditions.
Educate and counsel patients about pertinent information related to their medical conditions and prepare educational materials for patient use.
Contact insurance companies and provide comprehensive medical information to obtain authorization.
Ensure required testing and scheduling are completed before procedures and provide follow-up.
Work with health service coordinators to obtain necessary prior authorizations and schedule testing.
Assist with quality, education, and research efforts.
Perform in-office testing and other operational tasks as needed, including DRE exams, laboratory draws, urine collection, point-of-care testing, and rooming.
Travel to WVU Medicine Uniontown Primary Care Clinics.
Perform other department-specific duties as assigned.