Hybrid Care Navigator: Utilization Management

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients. We are a physician‑led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance. We are looking for a Care Navigator who is passionate about their work, eager to have fun, and motivated to be part of a fast‑growing organization in Henderson, NV. Care Navigator - Utilization Management Overall Purpose Under the supervision of the Medical Management Nurses, this position assists the nurses with Medical Management processes that do not require RN intervention, based on the scope of practice within the state. Through case finding, data and other tools, high‑risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers, and lower healthcare costs. Education and Experience High School graduate required Education as a medical assistant or nursing school student helpful Strong problem‑solving skills required Experience in a managed care organization preferred Knowledge of medical terminology required Excellent communication skills with patients, providers, internal and external customers required Must have excellent computer skills Must have excellent organizational skills and ability to work independently Knowledge, Skills and Abilities Friendly and compassionate disposition Proficiency with computer, software programs (i.e. Microsoft Word, Excel) and internet required Excellent communication and problem‑solving skills Excellent organizational and time management skills Ability to learn quickly Ability to handle a fast‑paced environment and prioritize tasks based on importance Strong interpersonal communication skills Ability to work independently or as part of a team Dedication to maintaining confidentiality of all patient records Knowledge of medical terminology required; ability to demonstrate knowledge of vital signs and other clinical skills to obtain and maintain employment Familiarity with EMR’s Essential Functions Promote the mission, vision and values of P3 Health Partners Coordinate patient care activities between UM and CM for assigned patient populations Provide administrative functions to support UM and CM Make initial follow‑up telephone call to patients discharged from a facility, acute or post‑acute, unless acuity requires RN to perform Provide outreach and guidance to non‑high‑risk patients Manage ER utilization report and interventions, per policy, to address inappropriate ER utilization Assist Medical Management team in gathering additional clinical information when applicable Support the Medical Management team with appropriate referrals, claims history or any other clinical information necessary Ensure timely and accurate documentation in systems Develop spreadsheets and other tools to support Medical Management team Assist patients in obtaining / coordinating community and other resources Work Location & Schedule This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week. Hourly Pay Rate range: $22.00 - $25.00 #J-18808-Ljbffr P3 Health Partners