Care Navigator - PCCN

Job Title

Care coordination is the deliberate organization of patient care activities to facilitate the appropriate delivery of health care services. This position works under the direction of a licensed health care professional and performs a variety of administrative duties in order help pediatric patients and families receive efficient, effective and customer-service focused navigation of the healthcare system. May be cross-trained on Care Management Resource Coordinator duties to provide coverage support to the Phoenix Children's Hospital inpatient care management team.

PCH Values

• Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
• Excellence in clinical care, service and communication
• Collaborative within our institution and with others who share our mission and goals
• Leadership that set the standard for pediatric health care today and innovations of the future
• Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

• Care Management Support

• a) Verifies insurance eligibility as needed and performs validation checks to ensure accurate contact information

• b) Verifies demographic information for the purposes of coordinating communication.

• c) Provides initial outreach to care management candidates, completes general sections of the Health Risk Assessment (HRA), and schedules time with the family for completion of HRA with the RN Care Manager.

• f) Coordinates and schedules interdisciplinary care team conferences.

• g) Serves as main point of contact for patients/families enrolled in care management services.

• h) Under the direction of the RN Care Manager and/or Social Worker, tracks implementation of the care plan and goal completion.

• i) Executes administrative portions of the care plan under the direction of the RN Case Manager and/or Social Worker. Activities may include, but are not limited to:

• Sending patient education or resources

• Sending primary care provider (PCP)/patient letters and medication lists

• Arranging durable medical equipment (DME)

• Arranging transportation

• Assisting with appointment scheduling and follow up on prescription fills/refills

• j) Logs all encounters with and about patients in the care management system.

• k) Escalates barriers to implementing the care plan to the RN Case Manager and/or Social Worker.

• Provider Network and Population Support

• a) Performs outbound calls on behalf of network practices to assist patients in obtaining necessary services to close gaps in care.

• b) Promotes in-network facilities and providers.

• c) When requested by families, facilitates three-way call to payers to re-assign PCP assigned to the patient.

• Customer Service

• a) Communicates clearly in both written and verbal communications with all internal and external customers.

• b) Provides excellent service routinely in interactions with all internal and external customers.

• c) Responds to email within 24 hours or one business day.

• Education

• Participates in a variety of educational programs to maintain current skills and competency levels

• Performs miscellaneous job related duties as requested.