Grace Health

Primary care & pediatric services, sliding-fee.

Patient Navigator

Clinical Support & Patient AdministrationPosted on Nov 11

Full-timeCorbin, KY, USANo salary listedIn-person

About the Job

Requirements

Required: A high school diploma or equivalent.
Preferred: Certified Pharmacy Technician, nursing license, or Certified Medical Assistant.
General computer skills.
Customer service experience.
Ability to communicate effectively verbally and in writing.
Attention to detail to ensure the accuracy of information relayed and processed.
Ability to exercise independent judgment and manage multiple priorities.
Adaptability to learning new systems and ongoing changes in the practice environment.
Problem-solving skills and ability to follow through on assigned tasks.
Ability to lift and/or move up to 50 pounds occasionally.
Ability to meet the physical demands of the job, including regularly talking or hearing; frequently standing, walking, sitting, and using hands to handle objects, tools, or controls; and occasionally reaching, stooping, kneeling, crouching, crawling, and tasting or smelling.
Vision abilities required include close, distance, color, and peripheral vision, depth perception, and ability to adjust focus.

Responsibilities

Serve as a liaison between patients, their families, and healthcare professionals, working with providers to meet patient needs and following approved guidelines, protocols, and standing orders.
Under pharmacist supervision and in conjunction with providers, assist patients with prescription refills, prior authorizations, DME and other forms, recertifications, and medication assistance programs.
Respond professionally and promptly to a high volume of inbound calls and inbox tasks, following standard operating procedures.
Collaborate with pharmacists to review and act on refill requests using approved protocols, and raise concerns with the pharmacist.
Schedule appointments according to protocols or provider orders.
Document all communication with patients and families in the electronic medical record.
Inform patients or their designated family members of laboratory and diagnostic results.
Establish and maintain accurate patient medication profiles for pharmacist review.
Maintain quality of work and meet service-level expectations.
Provide respectful and dignified customer service to patients and staff while following organizational protocols and guidelines.
Maintain Health Insurance Portability and Accountability Act (HIPAA) requirements and patient confidentiality.
Use current technology to enter and update patient demographics, process refills and discontinuations, and document as needed.
Listen actively to patients and confirm their needs are met before completing calls.
Escalate issues, concerns, or observations that may affect patients to a pharmacist or lead.
Collaborate with diagnostics, referrals, scheduling, community outreach, Grace Health pharmacies, and outside pharmacies.
Coordinate care with transportation services, home health agencies, physician offices, equipment companies, and nursing homes.
Assist providers with DME, guardianship, family and medical leave, and other forms for patients or their families.
Complete preauthorization and patient assistance program requests.
Document verbal orders or advice from providers and send documentation to providers for approval and signature.
Maintain current licenses or certifications, if applicable.
Perform other duties as assigned.
Participate in a team-based approach to patient care and coordinate care with community organizations, health plans, facilities, and specialists.
Understand and support population health management and proactively address the needs of patients and families served by the practice.
Communicate effectively with vulnerable patient populations.
Participate in continuous quality improvement activities, review and evaluate practice performance, identify improvement opportunities, and support quality outcomes.
Participate in the organization's advocacy program.
Follow organizational administrative, clinical, quality assurance, and personnel policies and procedures.
Maintain satisfactory attendance, including attending meetings and completing assigned tasks.
Document work assignments promptly and keep the supervisor informed about attendance and job assignments.
Multitask, work effectively and efficiently, and cooperate with providers, administration, and peers.

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 patients (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 involving both 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 communication and coordination skills to provide quality patient care.
Care coordination includes communication with community organizations, health plans, facilities, and specialists.
Care team members must understand and embrace the concept of population health management and proactively address the needs of patients and families served by the practice.
Team members must demonstrate the skills and knowledge necessary to communicate effectively with vulnerable patient populations.
Team members must participate in Continuous Quality Improvement (CQI) activities within the organization to ensure patients receive high-quality care.
All team members will be involved in improving quality outcomes.
Team members will participate in the review and evaluation of practice performance and help identify opportunities for improvement.
Team members will participate in Grace Health's advocacy program.

General Duties:

Follows all organizational policies and procedures, including administrative, clinical, quality assurance, and personnel policies.
Maintains satisfactory attendance, including attendance at meetings and completion of assigned tasks.
Maintains timely documentation of all work assignments.
Maintains patient confidentiality.
Routinely keeps the supervisor informed regarding attendance and job assignments.
Demonstrates flexibility and the ability to multitask.
Works effectively and efficiently.
Works cooperatively with providers, administration, and peers.

Qualification Requirements:

To perform this job successfully, an individual must be able to support and advance Grace Health's mission while satisfactorily performing each essential duty. The requirements listed below represent the knowledge, skills, and abilities required for the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
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 herein represent those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform essential 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 health center (FQHC). We provide primary healthcare services to underserved, underinsured, and uninsured individuals throughout southeastern Kentucky. Our mission is "to show the love and share the truth of Jesus Christ to southeastern Kentucky through access to compassionate, high-quality primary healthcare for the whole person."

The work environment characteristics described herein are representative of those employee encounters while performing the essential functions of this position. Reasonable accommodation may be provided to enable qualified individuals with disabilities to perform the essential functions of the position.

The noise level in the work environment is typically 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.

About the Company

Grace Health

Primary care & pediatric services, sliding-fee.

Grace Health is a Federally Qualified Health Center serving Southeastern Kentucky with a broad primary care offering. It provides pediatric and well-child care from birth, general primary care for all ages, and well-woman care, along with affordable prescriptions through a 340B pharmacy program and outreach and education. The organization operates a patient-centered medical home, meaning patients work with a care team to receive personalized, coordinated care and easier access to services. Grace Health accepts major insurance plans, Medicaid, Medicare, and KCHIP, and offers a sliding fee discount for the uninsured based on household income and size. Its mission is to share love and the truth of Jesus Christ through accessible, high-quality care for the whole person, focusing on compassionate service and helping patients navigate the healthcare system.

Company size: 51-200
Company stage: Grant
Total funding: $200K
Headquarters: Corbin, KY
Founded: 2008

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