Healthcare Access Navigator

WVU Medicine; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

UNTWN Uniontown Hospital in the United States is seeking a Patient Navigator to manage patient flow, coordinate services, and advocate for access to care within the healthcare system. You will verify insurance, educate providers on payor rules, and help patients navigate complex benefits to reduce delays and barriers.

Ideal candidates bring healthcare management education and 3+ years in the field, with strong communication and Microsoft Office skills.

Qualifications

• Bachelor’s degree in Healthcare Management, Public Health, or related field.
• Associate’s degree in Healthcare Management or Public Health or related field AND two (2) years of experience directly related to the duties and responsibilities specified.
• High school diploma or equivalent AND 4 years of experience directly related to the duties and responsibilities specified.

Responsibilities

• Establishes close relationships with and serves as primary point of contact for patients.
• Strategizes to help find payor population based on regional payer mix by collecting and analyzing market data.
• Verify insurance benefits and ensure coverage for obesity treatment for patients.
• Maintain a working knowledge of insurance payors pre-certification requirements for medications, diagnostic testing, surgery, referrals, etc.
• Educates providers and staff on payor regulations to prevent denials.
• Removes barriers to care by identifying resources for patients and helping them navigate through healthcare services.
• Coordinate appointments with service lines and labs/testing and manage wait-lists.
• Round on assigned patients daily and assist with discharge scheduling.
• Assist with getting prescriptions filled and assess cost/availability.
• Document patient information and obtain outside records as needed.
• Engage family/community resources for emotional, social, and financial needs.
• Collaborate with social services for resource/financial management and referrals.
• Other department specific duties may be assigned.
• Schedules AWV and runs quality reports; collaborates with clinic staff and physicians to improve quality benchmarks.
• Collaborates to manage complex patients with many co-morbid conditions.
• Educates and counsels patients concerning pertinent information for the medical condition.
• Contacts medical insurance companies to provide information to obtain authorization.
• Ensures all necessary testing and scheduling is complete prior to procedures; provides follow up.
• Works with health service coordinators to achieve pre-authorization and scheduling of testing.
• Provides assistance in quality, education, and research efforts.
• Performs in-office testing as needed (DRE, lab draws, urine collection, POCT testing).
• Travels to WVU Medicine Uniontown Primary Care Clinics.

Skills

Interpersonal communication

Patient interaction

Adaptability

Education

Bachelor’s degree in Healthcare Management, Public Health, or related field

Associate’s degree in Healthcare Management or Public Health + 2 years related experience

High school diploma or equivalent + 4 years related experience

Tools

Microsoft Office

Job description

UNTWN Uniontown Hospital in the United States is seeking a Patient Navigator to manage patient flow, coordinate services, and advocate for access to care within the healthcare system. You will verify insurance, educate providers on payor rules, and help patients navigate complex benefits to reduce delays and barriers.

Ideal candidates bring healthcare management education and 3+ years in the field, with strong communication and Microsoft Office skills.