QI-VBC Patient Navigator

Job Description

Job Description

POSITION SUMMARY
The Patient Navigator supports population health and care coordination efforts within a Federally Qualified
Health Center by engaging attributed patients assigned through Managed Care Organizations (MCOs), improving
access to preventive and primary care services, and assisting patients with Medicaid eligibility maintenance,
recertification, and reenrollment. This role helps advance value-based care goals by reducing barriers to care,
improving patient outcomes, and supporting continuity of insurance coverage. This is a 6-12 month position.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assist patients with Medicaid recertification, renewal applications, and reenrollment processes.
• Educate patients on required documents, deadlines, and eligibility requirements.
• Help patients’ complete applications and submit supporting documentation.
• Conduct outreach to patients attributed through Medicaid Managed Care Organizations (MCOs) to schedule
  primary care visits, annual wellness visits, preventive screenings, and follow-up appointments.
• Contact patients by phone, text, mail, and community outreach methods to encourage engagement in care.
• Educate patients on available health center services, benefits, and care coordination resources.
• Track outreach attempts and patient responses in the EMR (EClinicalWorks) and payer reporting systems.
• Assist in closing care gaps related to preventive screenings and chronic disease management.
• Monitor attributed patient panels to identify overdue services and support provider quality metrics.
• Collaborate with care teams to improve patient compliance with treatment plans and recommended services.
• Support initiatives tied to value-based payment contracts and quality performance targets.
• Identify social barriers affecting healthcare access, including transportation, food insecurity, housing
  instability, and language needs.
• Facilitate and schedule patient appointments/referrals and connect to internal/external community resources.
• Work closely with providers, case managers, social workers, and front desk staff to ensure continuity of care.
• Maintain accurate documentation of outreach, enrollment assistance, and patient encounters.
• Generate reports on outreach outcomes, recertification completion, and quality improvement efforts.
• Adhere to clinic departmental policies and procedures, which include Patient Safety initiatives, Patient Rights,
  and Health Insurance Portability and Accountability Act (HIPAA) Privacy standards.
• Support clinic quality improvement (QI) efforts. This includes clinic quality improvement and program
  monitoring, and directing Plan-Do-Study-Act (PDSA) change cycles.
• Attend relevant stakeholder and advisory meetings to support overall program implementation and evaluation.
• Attend external trainings and learning opportunities that expand content knowledge and best practices.
• Other duties as assigned.
  

HOURS OF WORK
Regular hours between 8:30 AM – 5:30 PM, Monday – Friday, with option of Telework (up to 50%).

REQUIRED QUALIFICATIONS, KNOWLEDGE & SKILL

• Associate or Bachelor’s degree preferred in health administration, public health, social work, or related field
• Experience in healthcare outreach, Medicaid enrollment, patient navigation, or community health preferred.
• Knowledge of Medicaid, Managed Care Organizations (MCOs), and Federally Qualified Health Center operations preferred.
• Ability to work collaboratively with physicians, staff, and external organizations
• Strong communication, customer service, and organizational skills.
• Ability to work with diverse populations and maintain confidentiality.
• Experience using electronic health records (EClinicalWorks) and Microsoft Office preferred.
• Proficiency with Microsoft Word and Excel