Patient Navigator-Pediatric Neurosurgery

WVU Medicine Golisano Children's; Morgantown (WV); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Job summary

WVUH West Virginia University Hospitals in Morgantown seeks a healthcare coordinator to serve as the primary contact for patients, coordinate scheduling, and help navigate payer requirements. You will analyze market data to identify payer mix, educate staff on payor regulations, and collaborate with social services to secure financial assistance and resources for patients.

This full-time position offers a 40-hour week in a clinical/office setting with opportunities to make a tangible impact on

Qualifications

• Bachelor’s degree in Healthcare Management, Public Health, or related field as a minimum.
• Associate’s degree plus 2 years directly related experience.
• High school diploma plus 4 years directly related experience.

Responsibilities

• Establishes close relationships with and serves as primary contact for patients.
• Strategizes to help find payor population based on regional payer mix by collecting and analyzing market data; verifies insurance benefits and coverage for obesity treatment.
• Maintain knowledge of insurance payors pre-certification requirements and review policies to prevent delays.
• Educates providers and staff on payor regulations to prevent denials.
• Removes barriers to care by identifying resources for patients and helping navigate healthcare services.
• Coordinates appointments with service lines, labs, and diagnostic testing.
• Monitors admissions and discharge scheduling and follow-up appointments.
• Assists with getting prescriptions filled; assesses cost and availability.
• Documents patient information and obtains outside records as needed.
• Engages family/community resources for emotional, social, and financial needs.
• Collaborates with social services for financial management, entitlements, and referrals.

Skills

Interpersonal communication

Negotiation skills

Microsoft Office

Education

Bachelor’s degree in Healthcare Management

Associate’s degree in Healthcare Management

High school diploma or equivalent

Bachelor’s degree in Healthcare Management or Public Health

Job description

Welcome! We’re excited you’re considering an opportunity with us! Below, you’ll find other important information about this position.

Minimum Qualifications

EDUCATION, CERTIFICATION, AND/OR LICENSURE

• Bachelor’s degree in Healthcare Management, Public Health, or other related field OR;
• 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;
• 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

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

Experience

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

CORE DUTIES AND RESPONSIBILITIES

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

• 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. Responsible for verifying insurance benefits and ensuring coverage for obesity treatment for patients.
• 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.
• Educates providers and staff on payor regulations in order to prevent denials.
• Removes barriers to care by identifying resources for patients and helping them navigate through healthcare services.
• Works with different service lines to assure coordination of appointments if applicable.
• 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.
• Will be aware if one of their assigned patients is admitted and will round on them daily / assists with scheduling discharge appointments.
• Assists with getting prescriptions filled. Assesses cost, availability etc.
• Documents patient information and obtains outside records, as needed.
• Engages family and/or community resources to meet the identified emotional, social, and financial needs of the patient.
• 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.
• Other department specific duties may be assigned.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to sit for extended periods of time.

WORKING ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Standard office/clinical environment.

Skills And Abilities

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

Additional Job Description

Scheduled Weekly Hours

40

Shift

United States of America (Non-Exempt)

Company

WVUH West Virginia University Hospitals

Cost Center

4757 UHA CH Pediatrics Surgery Neuro

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.