Care Navigator & Medical Assistant - Hybrid Role in Bozeman

Greater Good Health; Bozeman (MT); Hybrid; USD 28,000 - 41,000; Full time

Job summary

Greater Good Health is seeking a Care Navigator & Medical Assistant in Bozeman, MT to guide patients through in-clinic and home-based care. You’ll coordinate with Nurse Practitioners, schedule AWVs, and help ensure timely preventive care while building trust with the geriatric population.

The role emphasizes proactive outreach, documentation, and collaboration to improve outcomes and reduce readmissions. Hybrid work with a 7a-4p MST shift is available.

Responsibilities

• Conduct proactive outreach to schedule patient home, telehealth, and in-clinic visits to complete AWVs, ensuring patients receive timely preventative care and individualized care plans.
• Accept inbound calls from patients to schedule AWVs and address care-related questions or concerns.
• Connect with the geriatric population to build trusting, long-term relationships - making patients feel calm, comfortable, and heard throughout their care experience.
• Identify and address barriers to engagement, including transportation, language, health literacy, financial hardship, and other social and environmental factors.
• Outreach to patients to complete key preventative screenings (colon cancer, mammograms, diabetic retina scans, HbA1c, and more), documenting outreach and establishing follow-through plans.
• Partner closely with assigned GGH Nurse Practitioners (NPs) to co-manage their patient panel, serving as the day-to-day coordination hub for scheduling, care follow-through, and patient communication.
• Build and optimize driving routes for GGH Nurse Practitioners completing home visits, maximizing time spent with patients.
• Coordinate patient cancellations, reschedules, and add-on visits with the NP to ensure continuity of care and efficient schedule management.
• Retrieve and reconcile medical records from outside providers, hospitals, health systems, and community organizations to ensure the care team has a complete and current view of each patient’s health history.
• Manage patients post-discharge from hospital or skilled nursing facility settings, coordinating timely follow-up visits and facilitating care plan transitions to reduce readmission risk.
• Follow up with patients on outstanding provider orders - including lab work, imaging, specialist referrals, and durable medical equipment - ensuring completion and routing results back to the care team.
• Coordinate referrals and activities for high-risk programs, facilitating smooth transitions between care settings and service providers.
• Support the care team in identifying and closing quality gaps, including HEDIS measures and chronic disease management needs.

Job description

Greater Good Health is seeking a Care Navigator & Medical Assistant in Bozeman, MT to guide patients through in-clinic and home-based care. You’ll coordinate with Nurse Practitioners, schedule AWVs, and help ensure timely preventive care while building trust with the geriatric population.

The role emphasizes proactive outreach, documentation, and collaboration to improve outcomes and reduce readmissions. Hybrid work with a 7a-4p MST shift is available.