Patient Care Navigator

The Position: Performs as Home and Community-Based Care Based Alternatives (HCBA) department generalist and first point of contact.  Independently performs assigned duties. Interacts with all levels within and outside the organization to release or receive information and handles issues within scope of the role.  Requires extensive knowledge of the Coordinated Care Service Center and related vendors operations; communicates directly with participants and facilitates appointments and transportation.

Duties and Responsibilities:

Acts as initial point of contact for all department calls

Triages calls appropriately   

Provides administrative support for non–PACE care coordination functions including printing/faxing/scanning of participant documents

Orders office supplies for HCBA.

Manages ordering and installation of emergency alert system for participants

Initiates calls for clinical or administrative information as requested

Receives information and assures delivery to correct recipient.

Sends clinical information as directed.  Forwards incoming calls and or arranges call appointments as needed.

Arranges for discharge transport, follow up internal and external appointments with associated transport. 

Receives SNF acceptance information and notifies case manager.  Receives MD orders and assures distribution to appropriate parties. Communicates with SNF’s regarding CEI transfer paperwork and appropriate actions to be taken. Confirms receipt of orders and arrival of participant at SNF.

Open to best practice model suggestions.  Offers input and complies with department standards of care and practice as well as quality improvement activities. 

Listens to and documents participant concerns and facilitates satisfactory resolution.

Interfaces with participants for data collection, scheduling and care coordination needs.

Performs other duties as needed to support the CCSC team and assist with provision of  care coordination services.

Qualifications:

• Associate degree or higher, and 3-5 years of progressively responsible experience related to health plan operations
• Demonstrated excellent customer service and oral communication skills required
• Health plan experience with member coordination/communication and clerical management experience required (usually 3-5 years). 
• Basic knowledge of PC’s and related software required.  Accuracy, productivity, dependability and good attendance is critical. 
• Ability to perform duties in heavy workload environment.