Patient Navigator - Case Management

Quorum Health Corporation; Deming (NM); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Mountain West Medical Center is seeking a Patient Navigator to guide patients through the hospital and community systems, helping with appointments, insurance, and support services.

You will coordinate care, maintain communication with patients and providers, ensure records are available, and assist with patient portal, utilization management, and case management activities, including on-call and weekend rotation.

Qualifications

• High school diploma or GED required.
• 2 years experience in healthcare, hospital or clinic environment.
• Experience in customer relations.
• Ability to understand and apply Medicare and Medicaid ESRD rules and coordination of benefits requirements.
• Understanding of private insurance: PPO, HMO, POS, Medicare Advantage and Indemnity Plans.
• Organize and manage a large volume of documents with minimal supervision.
• Able to work cooperatively with others.
• Capable of data entry and productivity with Microsoft Office.
• Detail oriented and able to work under heavy workload.
• Energetic, optimistic and outgoing.

Responsibilities

• Coordinating appointments with providers to ensure timely delivery of services.
• Maintaining communication with patients, families, and providers to monitor satisfaction.
• Ensuring medical records are available at scheduled appointments.
• Facilitating linkages to follow-up services.
• Community outreach and building partnerships with local agencies.

Skills

Customer relations

Interpersonal communication

Organizational skills

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

Description

Patient Navigators are trained, culturally sensitive health care workers who provide support and guidance throughout the hospital and community. They help people "navigate" through the maze of doctors' offices, clinics, hospitals, outpatient centers, insurance and payment systems, patient support organizations, and other components of the health care system. Services are designed to support timely delivery of quality care and ensure that patients and families are satisfied with their encounters.

• Coordinating appointments with providers to ensure timely delivery of diagnostic and treatment services.
• Maintaining communication with patients, families, and the health care providers to monitor patient satisfaction with the care experience.
• Ensuring that appropriate medical records are available at scheduled appointments.
• Facilitating linkages to follow-up services.
• Community outreach and building partnerships with local agencies and groups (e.g., referrals to other services and/or support groups).

Assist in the Patient Portal process.

Patient navigator will assist in conducting an effective Utilization Management program along with discharge planning.

Patient navigator will be part of the Case Management team which will include the possibility of rotating an on call scheduled as well as rotating coverage on the weekends.

Qualifications

• High School Graduate or GED

2 years experience in healthcare, hospital or clinic environment

Experience in customer relations

Ability to understand and apply Medicare and Medicaid ESRD rules and regulations and coordination of benefits requirements

Understanding of private insurance industry: PPO, HMO, POS, Medicare Advantage and Indemnity Plans

• Ability to organize and manage a large volume of incoming documents accurately with minimum supervision
• Ability to work cooperatively with others
• Capable of data entry and productivity utilizing Microsoft Office Suite (Word, Excel, PP, etc)
• Detail oriented
• Able to work well under heavy workload
• Optimistic, energetic and outgoing

Equal Opportunity Employer
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