Patient Navigator

WVU Medicine; Ruby (AK); Presencial; USD 52.000 - 72.000; Jornada completa

Descripción de la vacante

WVUH West Virginia University Hospitals is seeking a Patient Navigator to manage patient flow through the healthcare system and serve as a key contact for patients. The role emphasizes insurance coordination, care access, and interdisciplinary collaboration in a standard office/clinical environment.

The position emphasizes supporting patients through the care journey, coordinating with payors, and helping families navigate resources and services within WVUHS.

Formación

• Excellent interpersonal communication and negotiations skills.
• Ability to work with people of all backgrounds and be adaptable to change.
• Proficient in Microsoft Office.

Responsabilidades

• Establishes close relationships with and serves as primary point of contact for patients.
• Stratifies payor population by collecting and analyzing market data; verifies insurance benefits for obesity treatment.
• Maintains knowledge of payor pre-certification requirements and proactively review policies to prevent delays.
• Educates providers and staff on payor regulations to prevent denials.
• Removes barriers to care by identifying resources and helping navigate healthcare services.
• Coordinates appointments with service lines and labs to assure coordination of care.
• Schedules patient appointments, reminders, and manages the wait-list.
• Assists with discharge scheduling and follow-ups as needed.
• Assists with getting prescriptions filled, assessing cost and availability.
• Documents patient information and obtains outside records when needed.
• Engages family/community resources for emotional, social, and financial needs.

Conocimientos

Interpersonal skills

Adaptability

Negotiation

Educación

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

Associate's degree in Healthcare Management, Public Health or related field & two years experience

High school diploma or equivalent & 4 years related experience

Herramientas

Microsoft Office

Descripción del empleo

The Patient Navigator is a member of a multi-disciplinary team and will assume responsibility and accountability for the management of patients through the healthcare system.

MINIMUM QUALIFICATIONS:

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

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

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

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

• 1. Bachelor’s degree in Healthcare Management or Public Health.

EXPERIENCE:

• 1. Three (3) years’ experience in the healthcare field. One (1) year of experience in statistical data analysis.

CORE DUTIES AND RESPONSIBILITIES:

• 1. Establishes close relationships with and serves as primary point of contact for patients.
• 2. Strategizes to help find payor population based on regional payer mix by collecting and analyzing market data. Responsible for verifying insurance benefits and ensuring coverage for obesity treatment for patients.
• 3. Maintain a working knowledge of insurance payors pre-certification requirements for medications, diagnostic testing, surgery, referrals, etc. Proactively review policies for changes to prevent delays in certification where applicable.
• 4. Educates providers and staff on payor regulations in order to prevent denials.
• 5. Removes barriers to care by identifying resources for patients and helping them navigate through healthcare services.
• 6. Works with different service lines to assure coordination of appointments if applicable.
• 7. Schedules patient appointments and adjusts as needed. This includes coordinating appointments with laboratory or diagnostic testing, ensuring adherence to appointments, reminder calls, and managing the patient wait-list.
• 8. Will be aware if one of their assigned patients is admitted and will round on them daily / assists with scheduling discharge appointments.
• 9. Assists with getting prescriptions filled. Assesses cost, availability etc.
• 10. Documents patient information and obtains outside records, as needed.
• 11. Engages family and/or community resources to meet the identified emotional, social, and financial needs of the patient.
• 12. Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to, financial assistance coordination and referrals, entitlement program coordination and referrals, patient benefit coordination, assessment for appropriate usage of healthcare resources, and clinical cost efficiency.
• 13. Other department specific duties may be assigned.

PHYSICAL REQUIREMENTS:

• 1. Ability to sit for extended periods of time.

WORKING ENVIRONMENT:

• 1. Standard office/clinical environment.

SKILLS AND ABILITIES:

• 1. Possesses excellent interpersonal communication and negotiations skills in interactions with patients, families, providers, and healthcare team colleagues.
• 2. Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open-minded, and adaptable to change.
• 3. Proficient in Microsoft Office.

Additional Job Description:

Scheduled Weekly Hours:

40

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

WVUH West Virginia University Hospitals

Cost Center:

8168 UHA Physical Medicine and Rehabilitation

Address:

1 Medical Center Drive
Morgantown
West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.