Patient Care Navigator

Join Our Team at Valley-Wide Health Systems, Inc.

We are currently seeking Patient Care Navigator to join our team, where you will play a key role in assisting patients with navigating the healthcare system, overcoming financial and social barriers, and improving health outcomes. This position fosters a culture of patient-centered care, enhances experiences, improves operations, and promotes excellence in quality and safety.

Key Responsibilities:

Patient Assistance & Care Coordination Facilitates patient access to care by assisting with healthcare navigation, addressing barriers to care, and coordinating communication between patients and the healthcare team.

Assist patients in resolving issues related to healthcare access, financial barriers, and social needs.

Respond to patient inquiries via phone, patient portal, and in person, ensuring timely, professional, and compassionate communication.

Help patient's complete enrollment applications for programs such as Senior Dental, Medicaid, Sliding Fee Discount Program, and Med Ride.

Request interpreters, transportation services, prescription assistance, and other supportive services as needed.

Verify and collect documentation to support eligibility for state and local assistance programs.

Coordinate with nursing and clinical staff to address urgent patient concerns and ensure appropriate follow-up.

Facilitate follow-up appointments before patients leave the clinic whenever possible.

Maintain confidentiality of all patient information in accordance with HIPAA and organizational policies.

Health Navigation, Referrals & Scheduling Supports patients throughout their healthcare journey by coordinating referrals, authorizations, appointments, and ongoing care needs.

Conduct comprehensive assessments for new and referred patients, evaluating clinical and psychosocial needs.

Guide patients in understanding healthcare recommendations, treatment plans, available services, and medical benefits.

Coordinate specialty referrals, imaging, diagnostic testing, and follow-up appointments.

Process, monitor, and document prior authorizations for specialty care, imaging, medications, and diagnostic procedures.

Follow up on pending or denied authorizations and assist with appeals as appropriate.

Manage incoming referrals and communicate with patients, providers, and outside facilities to ensure continuity of care.

Assist patients in establishing a Primary Care Provider within the Patient-Centered Medical Home model.

Coordinate communication with insurance providers, specialty offices, and community resources to facilitate timely patient care.

Team Collaboration & Documentation Collaborates with interdisciplinary teams while maintaining accurate documentation and supporting clinic operations.

Participate in daily team huddles and collaborate with providers, nursing staff, care teams, and support personnel.

Document patient interactions, referrals, authorizations, social determinants of health screenings, and case management activities within the Electronic Health Record (EHR).Manage patient portal requests, telephone encounters, and provider communications in a timely manner.

Assist in running reports and supporting quality improvement initiatives by scheduling preventive and routine healthcare services.

Maintain accurate records for audits, referrals, and authorization tracking.

Provide additional clinic support as needed to promote efficient workflow and exceptional patient care.

Perform other duties as assigned.

Qualifications & Skills:

Education:

High school diploma required; bachelor’s degree in business, Healthcare Administration, Human Services, Social Work, or a related field preferred OR one (1) year of qualifying experience.

Experience:

1+ year of experience in customer service,…