patient navigator

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: 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 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 Ability to sit for extended periods of time. Working Environment 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: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 415 SYSTEM Population Health Management The West Virginia University Health System is West Virginia’s largest health system and the state’s largest employer with more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues. The Health System is comprised of 25 hospitals - including J.W. Ruby Memorial Hospital, an 880-bed academic medical center, and the 150-bed WVU Medicine Children’s Hospital in Morgantown, West Virginia - and five institutes. To learn more, visit WVUMedicine.org. #J-18808-Ljbffr WVU Medicine