Patient Navigator - Pediatrics

Job Description

Job Description

Summary:

The Patient Navigator serves as a liaison between patients, their families and healthcare professionals. They work closely, as a team, with the provider(s) to meet the needs of the patients and follows approved guidelines, protocols, and standing orders.

The Patient Navigator is responsible, under the supervision of a pharmacist and in conjunction with providers, assisting with the needs of patients including, but not limited to, refilling prescriptions, preparing prior authorizations, completing DME and other forms requesting recertifications, and evaluating medication assistance programs.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Respond professionally to a high volume of inbound calls/inbox tasks in a timely and efficient manner, following standard operating procedures.
• Works in collaboration of the Pharmacists on the process of reviewing and acting upon refill requests, utilizing the Grace Health approved protocols and raising any concerns with the Pharmacist.
• Schedule appointments following protocol or providers orders.
• Document all communication with patients and family in EMR.
• Inform patients or designated family member of lab/diagnostic results.
• Accurately establish and maintain patient medication profiles for review by the pharmacist.
• Consistently produce quality of work that is above average and meet service level expectations.
• Provide superior customer service to our patients and staff by treating them with respect and dignity while following Grace Health protocols and guidelines.
• Maintains HIPAA requirements.
• Proficient in current technology to provide tasks: entering and updating patient demographics, processing refills and discontinues, and documenting as needed.
• Practice active listening when speaking to patients to ensure the needs of the customer are met prior to completing the call.
• Escalate to Pharmacist/Lead any issues, concerns, or observations that may impact the patient.
• Collaborates with other departments such as diagnostics, referrals, scheduling, community outreach, Grace Health pharmacies, and outside pharmacies.
• Facilitates care with transportation services, home health agencies, physician offices, equipment companies, and nursing homes.
• Assist provider with completing DME, Guardianship, FLMA, and other forms for patient (or family when applicable).
• Complete preauthorization and patient assistant program requests.
• Document verbal order/advice from providers (sending documentation to providers to sign off).
• Maintain current license/certification(s), if applicable.
• Other duties as assigned.

OTHER ESSENTIAL DUTIES and RESPONSIBILITIES:

• Grace Health recognizes that managing patient care is a team effort that involves clinical and non-clinical staff.  All employees must embrace a team-based approach to patient care and understand that each role is important to our success.
• Team members must demonstrate excellent team communication and coordination to provide quality patient care.
• Care coordination includes communicating with community organizations, health plans, facilities, and specialists.
• Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice.
• Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations.
• Team members must participate in Continuous Quality Improvement activities within the organization to ensure patients receive high-quality care.
• Team members will participate in the review and evaluation processes of practice performance and help identify improvement opportunities.
• Team members will participate in Grace Health's advocacy program.

GENERAL DUTIES:

• Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel.
• Maintains good attendance (daily, meetings, and other assignment tasks).
• Maintains timely documentation of all work assignments.
• Maintains patient confidentiality.
• Routinely keeps supervisor informed about attendance and job assignments.
• Flexible in being able to multitask.
• Works effectively and at an efficient pace.
• Works cooperatively with providers, administration, and peers.

QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and perform each essential duty satisfactorily. The requirements below represent the required knowledge, skill, and/or ability. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

SKILLS:

• Ability to effectively communicate both verbally and in writing.
• Attention to detail is key to ensure accuracy of information relayed and processed.
• Self-motivated and able to exercise independent judgement.
• Ability to manage multiple priorities.
• Adaptable to learning new systems and continual changes in practice environment.
• Team player with a customer-oriented approach and desire to assist people.
• Problem-solving skills and ability to follow through on tasks assigned.

EDUCATION and/or EXPERIENCE:
Required: High school diploma or equivalent.
Preferred: Certified Pharmacy Technician, Nursing license, or Certified Medical Assistant. General computer skills. Customer service experience.

PHYSICAL DEMANDS:            
The physical demands described here represent those that an employee must meet to perform the essential functions of this job successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform these functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand, walk, sit, and use hands to finger, handle, or feel objects, tools, or controls. The employee occasionally is required to reach with hands and arms, stoop, kneel, crouch, or crawl, and taste or smell. The employee must occasionally lift and /or move up to 50 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT:
Grace Health is a faith-based, federally qualified community health center (FQHC) in southeastern Kentucky. We provide primary health services to underserved, underinsured, and uninsured individuals. Our mission is “to show the love and share the truth of Jesus Christ to southeastern Kentucky through access to compassionate, high-quality, primary health care for the whole person.” The work environment characteristics described here represent those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. The noise level in the work environment is usually moderate.

Grace Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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