Patient Care Navigator Iii Apply
At Rely Health, each patient receives a steadfast companion on their healthcare journey. Empowered with technology, our patient care navigators not only ensure high-quality engagements, but also make comprehensive care more cost-effective and accessible for all patients.
The Patient Care Navigator guides individuals and their families throughout the healthcare journey by combining human interaction and technological tools to facilitate a seamless experience and transition of care with appropriate follow-through and monitoring of the care plan while the individuals learns to self-navigate the healthcare system. The navigator helps reduce worry and frustration for individuals, their families and caregivers, by means of effective communication, coordination, and efficiency across the healthcare system.
The Navigator focused on specific medical conditions or diagnoses will be required to attend specialized training and demonstrate the skills learned to continue employment in this position.
The Navigator III is a subject matter expert and trains new navigators and current navigators on new processes/use of technology tools. The Navigator III helps teammates with complex patients and escalated cases to guide the teammate and ensure the patients needs are being satisfied.
Care Navigation
- Understands broad principles related to care management, healthcare operations, value-based care, and insurance
- Contributes to problem solving with the team through communication, collaboration, data collection, critical thinking, evaluation of options and solutions to further the patient progress towards care plan goals
- Assists patients with medical coordination matters such as obtaining a primary care or specialist provider, scheduling follow-up appointments, and providing linkages to pharmacy resources.
- Assists patients with social coordination matters, such as referring patients to a financial counselor, insurance enrollment specialist or social worker/case manager for additional resources.
- Utilizes motivational interviewing techniques to communicate with patients in a respectful, culturally appropriate, non-judgmental manner.
- Regularly communicates with care team members to provide feedback around process improvement of services offered within the community, and to expand knowledge of those services that can better serve the patient and increase effectiveness of the role.
- Maintains frequent contact with client or hospital/clinic leadership to assist with other duties as assigned for participation in client or hospital/clinic initiatives.
- Receives patient requests for assistance and refers patient to appropriate member of the care team for resolution unless Navigator can resolve on his/her own and within the scope of the position.
- Performs duties in compliance with Health Insurance Portability and Accountability Act (HIPAA) and understand the importance of protecting patient information.
- Develops expertise in insurance benefits and exclusions related to treatment.
- Maintains documentation of all client encounters in appropriate software applications or tools; completes reporting requirements according to program standards.
- Enter detailed information into company proprietary software while conversing with patients.
- Supports quality initiatives collaboratively developed with client or hospital/clinic leadership teams and Rely Health through campaign outreaches designed to engage patient and caregivers to increase treatment adherence, and better health outcomes for our patients.
- Develops relationships with community resources and available services, such as (but not limited to) mental health, housing, food, and employment assistance; provides information about services to patients, as needed.
- Develops relationships with referral sources, clinics, facilities, community services, and members of the client team (e.g. Business Development), in order to improve access to care in the community.
- Coordinates communication between the patient and their support systems, e.g., legal entities such as probation officers, community case managers, sponsors.
- Regularly engages with and integrates new technology solutions into the patient care navigation process to enhance job efficiency and ensure seamless patient experiences.
- Remains adaptable and responsive to the continuous evolution of healthcare technology solutions, including software updates, new tools and digital communication platforms.
- Trains new team members on the role, including evaluations and providing feedback as necessary. (Some travel may be required)
- Trains other team members on new technology and platform capabilities and elicits feedback to provide to appropriate team members for product enhancements.
- Create training content for team members on the use of technology tools and workflows.
- Coordinates training for new team members
- Assists with real time service recovery needs to clients to understand issues/concerns and implement coaching and/or process improvement plans to address the issues/concerns.
- Collaborates with immediate manager to identify workflow changes.
Requirements
Minimum Required Qualifications:
- High school diploma or GED
- Knowledge of health insurance, billing practices and intricacies of healthcare systems
- Ability to maintain a high level of productivity autonomously
- 2+ years of patient care navigation experience
- Familiarity with healthcare technology platforms and tools
- Understanding of and ability to comply with all HIPAA and confidentiality requirements
- Ability to work independently and lead a team in a fast-paced, demanding environment with minimal supervision.
- Ability to manage and oversee multiple tasks simultaneously, including high daily call volume
- Ability to communicate effectively, both orally and in writing
- Ability to create effective rapport with a diverse group of patients and care providers
- 1+ years of experience leading people
Preferred Qualifications:
- Experience working with individuals within hospitals or public health settings.
- Experience with underserved populations.
- Knowledge of Medicare, Medicaid and commercially insured payer common practices and policies
- 40+ wpm typing proficiency
- Experience documenting in electronic health record system or similar
- Experience using technology, apps, software
Competencies (Knowledge/Skills/Abilities):
- Knowledge of medical terminology.
- Knowledge of Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) rules and practices.
- Knowledge of computer skills using Microsoft Word, Excel, and Outlook, as well as video conferencing and using the Internet.
- Ability to learn new technology solutions and be ok with constant change in technology
- Demonstrated strong customer service orientation skills and telephone etiquette.
- Ability to communicate effectively in both verbal and written forms.
- Ability to remain organized and manage competing priorities.
- Ability to work within established timeframes as part of a care team or independently.
- Ability to develop relationships with patients and care team members.
- Ability to respectfully listen to patient and care team without interruption to understand patient needs, expectations, values, and perspectives; ask appropriate questions to ensure understanding; and respond appropriately.
- Ability to use logic and reasoning to approach problems and identify alternative solutions.
- Flexible and creative problem solver.
- Non-judgmental and energetic.
Rely Health does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Rely Health is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.
Benefits
- Medical, Dental Vision
- Life Insurance
- Short and Long Term Disability
- 11 Paid Holidays
- Vacation Time
- Sick Time
- 401(k)
- Technology reimbursement
- Professional development
Target Start Date:November 1, 2024
Location:Olympia Fields, IL
FLSA Status:Non-Exempt
Job Status:Full Time
Work Schedule:Monday - Friday with occasional evenings and/or weekends
Vehicle Required:No
Amount of Travel Required:5% - Local Area Travel
Reports To:Supervisor, Program Operations
Salary Range: $23-$25/hr DOE
