Geriatric Care Navigator: Transitions & Advocacy

Community-Home-Physicians; McHenry (IL); On-site; USD 61,606,000 - 85,962,000; Full time

Benefits offered by this job

401(k) with company matching

Comprehensive Health, Dental, and VIs0

Health Savings Account (HSA)

Life insurance

Generous Paid Time Off (PTO)

Travel reimbursement for community/fac

Job summary

Community Physicians is seeking a Patient Care Navigator to bridge clinicians, facility staff, patients and families, ensuring seamless transitions of care across settings. The role combines administrative medical support and patient advocacy to deliver patient- and family-centered care at skilled nursing and post-acute sites.

Responsibilities include EMR data entry, coordinating follow-ups, conducting social risk assessments, enrolling patients in programs, and collaborating with an

Qualifications

• High school diploma or equivalent is required.
• Graduate of an accredited Medical Assistant program is required.
• Certified Medical Assistant (CMA) is highly preferred.
• Current Basic Life Support (BLS) Certification.
• Minimum 1–3 years of experience with EMR/EHR systems and taking vital signs.
• 5–7 years of experience in Skilled Nursing Facilities.
• Strong knowledge of medical terminology.

Responsibilities

• Collaborate with patients, families, and multidisciplinary medical professional team.
• Support patients and family members with transitions to the next level of care, including setting up follow-up appointments.
• Perform chart creation and data entry of patient demographics, medications, and diagnoses within the EMR system.
• Assist with transition clinic services, patient intake, phone calls, and documentation.
• Conduct patient social risk factor assessments to identify unmet health or social needs.
• Identify high-risk, complex patients who would benefit from transition services, chronic disease management, or remote monitoring, and assist them with enrollment.
• Attend IDT (Interdisciplinary Team) plan of care meetings at facilities and communicate daily with practitioners and Nurse Case Managers.
• Assist in the collection of key quality metrics and program performance improvement data.

Skills

Bedside manner

Problem-solving

Communication skills

Compassionate care

Travel to facilities

Education

High school diploma or equivalent

Graduate of accredited Medical Assistant program

Certified Medical Assistant (CMA) preferred

Current Basic Life Support (BLS) Certification

Tools

EMR/EHR systems

Job description

Community Physicians is seeking a Patient Care Navigator to bridge clinicians, facility staff, patients and families, ensuring seamless transitions of care across settings. The role combines administrative medical support and patient advocacy to deliver patient- and family-centered care at skilled nursing and post-acute sites.

Responsibilities include EMR data entry, coordinating follow-ups, conducting social risk assessments, enrolling patients in programs, and collaborating with an