Patient Care Navigator

Paycom; Ordway (CO); On-site; USD 28,000 - 35,000; Full time

Benefits offered by this job

Free Health Insurance

Air Ambulance Coverage

Life Insurance

Job summary

Valley-Wide Health Systems, Inc. in Ordway, CO is seeking a Health Navigator to help patients resolve barriers to healthcare access and enroll in programs such as Medicaid, Senior Dental, Sliding Fee Discount, and MedRide, coordinating with clinicians to ensure timely follow-up.

The role requires strong customer service, bilingual abilities preferred, and a commitment to HIPAA privacy while guiding patients through referrals, authorizations, scheduling, and community resources to promote

Qualifications

• Education required: high school diploma; bachelor's degree preferred or 1 year of qualifying experience.

Responsibilities

• Assist patients in resolving issues related to healthcare access, financial barriers, and social needs.
• Respond to patient inquiries via phone, patient portal, and in person, ensuring timely, professional, and compassionate communication.
• Help patients complete enrollment applications for programs such as Senior Dental, Medicaid, Sliding Fee Discount Program, and MedRide.
• Request interpreters, transportation services, prescription assistance, and other supportive services as needed.
• Verify and collect documentation to support eligibility for state and local assistance programs.
• Coordinate with nursing and clinical staff to address urgent patient concerns and ensure appropriate follow-up.
• Facilitate follow-up appointments before patients leave the clinic whenever possible.
• Maintain confidentiality of all patient information in accordance with HIPAA and organizational policies.
• Conduct comprehensive assessments for new and referred patients, evaluating clinical and psychosocial needs.
• Guide patients in understanding healthcare recommendations, treatment plans, available services, and medical benefits.
• Coordinate specialty referrals, imaging, diagnostic testing, and follow-up appointments.
• Process, monitor, and document prior authorizations for specialty care, imaging, medications, and diagnostic procedures.
• Follow up on pending or denied authorizations and assist with appeals as appropriate.
• Manage incoming referrals and communicate with patients, providers, and outside facilities to ensure continuity of care.
• Assist patients in establishing a Primary Care Provider within the Patient-Centered Medical Home model.
• Coordinate communication with insurance providers, specialty offices, and community resources to facilitate timely patient care.
• Participate in daily team huddles and collaborate with providers, nursing staff, care teams, and support personnel.
• Document patient interactions, referrals, authorizations, social determinants of health screenings, and case management activities within the Electronic Health Record (EHR).
• Manage patient portal requests, telephone encounters, and provider communications in a timely manner.
• Assist in running reports and supporting quality improvement initiatives by scheduling preventive and routine healthcare services.
• Maintain accurate records for audits, referrals, and authorization tracking.
• Provide additional clinic support as needed to promote efficient workflow and exceptional patient care.
• Perform other duties as assigned.

Skills

Customer service

Interpersonal communication

Critical thinking

Organizational skills

Time management

Multitasking

MS Word

MS Excel

MS Outlook

EHR systems

Referral management

Scheduling

Insurance authorization

Spanish (preferred)

Education

High school diploma

Bachelor’s degree preferred

Job description

Job Location: Valley Wide Ordway - Ordway, CO 81063, Position Type: Full Time, Salary Range: $20.06 - $25.07 Hourly, Join Our Team at Valley-Wide Health Systems, Inc.

Key Responsibilities:

Patient Assistance & Care Coordination

• Assist patients in resolving issues related to healthcare access, financial barriers, and social needs.
• Respond to patient inquiries via phone, patient portal, and in person, ensuring timely, professional, and compassionate communication.
• Help patient's complete enrollment applications for programs such as Senior Dental, Medicaid, Sliding Fee Discount Program, and MedRide.
• Request interpreters, transportation services, prescription assistance, and other supportive services as needed.
• Verify and collect documentation to support eligibility for state and local assistance programs.
• Coordinate with nursing and clinical staff to address urgent patient concerns and ensure appropriate follow-up.
• Facilitate follow-up appointments before patients leave the clinic whenever possible.
• Maintain confidentiality of all patient information in accordance with HIPAA and organizational policies.

Health Navigation, Referrals & Scheduling

• Conduct comprehensive assessments for new and referred patients, evaluating clinical and psychosocial needs.
• Guide patients in understanding healthcare recommendations, treatment plans, available services, and medical benefits.
• Coordinate specialty referrals, imaging, diagnostic testing, and follow-up appointments.
• Process, monitor, and document prior authorizations for specialty care, imaging, medications, and diagnostic procedures.
• Follow up on pending or denied authorizations and assist with appeals as appropriate.
• Manage incoming referrals and communicate with patients, providers, and outside facilities to ensure continuity of care.
• Assist patients in establishing a Primary Care Provider within the Patient-Centered Medical Home model.
• Coordinate communication with insurance providers, specialty offices, and community resources to facilitate timely patient care.

Team Collaboration & Documentation

• Participate in daily team huddles and collaborate with providers, nursing staff, care teams, and support personnel.
• Document patient interactions, referrals, authorizations, social determinants of health screenings, and case management activities within the Electronic Health Record (EHR).
• Manage patient portal requests, telephone encounters, and provider communications in a timely manner.
• Assist in running reports and supporting quality improvement initiatives by scheduling preventive and routine healthcare services.
• Maintain accurate records for audits, referrals, and authorization tracking.
• Provide additional clinic support as needed to promote efficient workflow and exceptional patient care.
• Perform other duties as assigned.

Qualifications & Skills:

Education: High school diploma required; bachelor’s degree in business, Healthcare Administration, Human Services, Social Work, or a related field preferred OR one (1) year of qualifying experience.

Experience: 1+ year of experience in customer service, support, coordination, or case management.

Skills:

• Strong customer service and interpersonal communication skills.
• Excellent critical thinking, organizational, and problem-solving abilities.
• Ability to prioritize multiple tasks and work effectively in a fast-paced healthcare environment.
• Proficiency in Microsoft Word, Excel, Outlook, and Electronic Health Record (EHR) systems.
• Knowledge of referral management, appointment scheduling, and insurance authorization processes preferred.
• Ability to communicate professionally in person, over the phone, and through electronic communication.
• Ability to collaborate effectively with providers, nursing staff, and interdisciplinary healthcare teams.
• Familiarity with community resources and patient assistance programs.
• Sensitivity to the needs of low-income, underserved, and diverse populations.
• Basic Life Support (BLS) certification/training will be provided upon employment.

Bilingual Spanish-speaking preferred but not required.

Why Join Valley-Wide?

Valley-Wide Health Systems, Inc. is dedicated to providing high-quality, patient-centered healthcare to all individuals across our multi-county service area in southern Colorado. As a non-profit, Federally Qualified Health Center (FQHC), we offer premier primary and preventive care through our 34 service sites strategically located in rural communities.

We offer a comprehensive benefits package, including:

• Free Health Insurance (additional plan options available)
• Employer-paid Air Ambulance Coverage (MASA)
• Employer-paid Basic Life, LTD, STD
• Retirement Match
• Health, Dental, Vision Insurance, HRA, FSA, DCA, Retirement Plan
• Generous Paid Leave:
  • Vacation: 10 days accrued per year
  • Sick Leave: 12 days accrued per year
  • Holidays: 7 days per year + 3 Floating Holidays

Equal Opportunity Employer Statement:

Valley-Wide Health Systems, Inc. is an Equal Opportunity Employer. We do not discriminate based on race, color, religion, national origin, sex, age, disability, or any other status protected by law. All qualified applicants will receive equal opportunity, with hiring decisions based on job-related factors.

Employee Rights Under the Family and Medical Leave Act (FMLA) For more information on employee rights under FMLA, please visit: FMLA Employee Rights :