Care Navigator: Plan & Patient Care Coordination

PruittHealth; Norcross (GA); On-site; USD 42,000 - 62,000; Full time

Job summary

PruittHealth is seeking a Plan Care Navigator to serve as a primary contact for members in the Premier program. The role focuses on care coordination, problem solving, and proactive outreach to prevent gaps in care, with emphasis on documentation and collaboration with clinicians.

Responsibilities include assessing needs via phone, coordinating services across providers, and guiding members through benefits and referrals while maintaining HIPAA compliance.

Qualifications

• Minimum education: High School diploma or GED.
• Preferred: Associate degree or coursework in health sciences, or Medical Assistant accreditation, or BSW.

Responsibilities

• Handle inbound calls, assess member needs, and provide guidance.
• Provide live phone support and answer questions before appointments.
• Coordinate care workflows from outreach to case resolution.
• Escalate clinical concerns to RNs as needed.
• Document all interactions in EHR and call scripts.

Skills

Care coordination

Customer service

Communication skills

HIPAA compliance

EHR proficiency

CMS knowledge

Org & planning

Problem solving

Team collaboration

Education

Associate degree or health sciences coursework

Medical Assistant certification

Bachelor of Social Work

Tools

EMR systems

Care management platform

Microsoft Office

Reporting software

Job description

PruittHealth is seeking a Plan Care Navigator to serve as a primary contact for members in the Premier program. The role focuses on care coordination, problem solving, and proactive outreach to prevent gaps in care, with emphasis on documentation and collaboration with clinicians.

Responsibilities include assessing needs via phone, coordinating services across providers, and guiding members through benefits and referrals while maintaining HIPAA compliance.