Patient Navigator

Patient Navigator

The Patient Navigator serves as a dedicated member of the Porch Light Health care team, helping patients overcome barriers that may interfere with their ability to access, engage in, and remain connected to treatment. Acting as a trusted guide and advocate, the Patient Navigator assists patients in navigating insurance coverage, financial assistance programs, transportation resources, community services, and other social determinants of health that impact recovery and overall well-being.

This role works closely with providers, Patient Care Coordinators, the Call Center, Revenue Cycle, and community partners to proactively identify and resolve challenges before they disrupt treatment. While not providing clinical services, counseling, case management, or social work services, the Patient Navigator plays a critical role in supporting patient engagement, retention, and successful treatment outcomes.

Essential Responsibilities

Insurance and Benefits Navigation

• Assist patients with Medicaid enrollment, renewal, and eligibility maintenance.
• Conduct proactive outreach to patients approaching Medicaid renewal deadlines.
• Educate patients regarding Medicaid requirements, workforce exemptions, reporting obligations, and other program requirements.
• Assist patients in navigating Medicare, Marketplace (ACA), and other available insurance options.
• Coordinate with Revenue Cycle and eligibility teams to address coverage concerns before treatment is interrupted.
• Help patients understand insurance benefits as they relate to Porch Light Health services.

Financial Assistance and Affordability

• Educate patients regarding self-pay options, payment plans, scholarship programs, hardship assistance, and other financial resources.
• Assist patients with completion of financial assistance applications and required documentation.
• Work collaboratively with internal teams to identify solutions that support continued treatment engagement.

Transportation and Access Support

• Assess transportation barriers that may impact appointment attendance.
• Connect patients with Medicaid transportation benefits, Uber Health resources, and other transportation programs.
• Coordinate transportation support when appropriate to reduce missed appointments and treatment interruptions.

Patient Engagement and Retention

• Conduct outreach to patients who have missed appointments, disengaged from care, or are at risk of treatment interruption.
• Identify and address non-clinical barriers affecting treatment adherence.
• Partner with providers, PCCs, and operational teams to support patient re-engagement efforts.
• Assist patients in resolving administrative, financial, or logistical challenges that may prevent them from remaining in care.
• Document & engage with community organizations to raise awareness of service delivery and build a network of resources to support a variety of patient needs.

Social Determinants of Health Support

• Connect patients with community resources related to food insecurity, housing instability, employment assistance, utility assistance, legal aid, and other social needs.
• Assist patients with applications and enrollment processes for programs such as SNAP and other public assistance programs.
• Maintain current knowledge of community resources available within assigned markets.
• Build and maintain relationships with community organizations and resource providers.

Healthcare Navigation

• Assist patients in accessing primary care, specialty care, behavioral health services, and other healthcare resources as appropriate.
• Support patients in understanding and navigating healthcare systems and referral processes.
• Help patients access telehealth services and address technology-related barriers to care.

Documentation and Reporting

• Document patient interactions and interventions in accordance with company policies and procedures.
• Track outcomes related to patient assistance activities, including benefit enrollments, transportation interventions, resource referrals, and patient re-engagement efforts.
• Participate in reporting and quality improvement initiatives focused on access, retention, and patient success.

Qualifications

Preferred Education and Experience

• Associate's degree in Human Services, Healthcare Administration, Social Work, Psychology, Public Health, or a related field preferred.
• Equivalent combination of education, experience, and demonstrated success working with patients will be considered.
• Experience in healthcare, patient services, customer service, care coordination, patient advocacy, community resources, insurance navigation, or social services preferred.
• Experience supporting underserved, vulnerable, or behavioral health populations preferred.
• Experience working with rural and remote populations, specifically navigating medical, behavioral health, and community services in resource-limited communities.

Required Qualifications:

• Proficiency in insurance eligibility verification, EOB interpretation, and benefit navigation, including deductibles, copays, coinsurance, and out-of-pocket maximums.
• Ability to accurately determine and communicate patient financial responsibility for services. Experience with Medicaid, Medicare, ACA Marketplace, commercial insurance, and financial assistance programs required.
• Required to travel up to 25%
• Transportation to and from Regional locations as needed for travel

Knowledge, Skills and Abilities

• Demonstrated ability to build trust and rapport with patients.
• Strong problem-solving and resource navigation skills.
• Ability to manage multiple patient needs simultaneously.
• Strong organizational and follow-up skills.
• Ability to work collaboratively across departments and community partners.
• Commitment to patient-centered care and recovery support.

Success Measures

• Medicaid enrollments and renewals completed.
• Insurance coverage interruptions prevented.
• Transportation barriers resolved.
• Community resource referrals completed.
• Patients successfully re-engaged in treatment.
• Reduction in avoidable treatment disruptions due to non-clinical barriers.
• Patient satisfaction and engagement outcomes.

Work Setting & Hours:

Time will be split being remote 50% of the time, 25% travel to designated region, 25% in clinic. Standard 40 hours per week, 8:00am - 4:30pm, M-F. Non-exempt hourly.

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Why This Role Matters

At Porch Light Health, we believe recovery should not be limited by transportation challenges, insurance complexities, financial hardship, or lack of access to community resources. The Patient Navigator helps ensure that patients have a knowledgeable advocate and guide who can help remove barriers and keep them connected to the care and support they need to succeed.

PLH is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, age, genetic information, or any other characteristic protected by law.

Anticipated Application Window - This role is anticipated to close within 30 days from the date of posting. However, if the position has not been filled, PLH may keep the application period open longer.

Porch Light Health