Patient Care Navigator

Job Location:

Valley Wide Ordway - Ordway, CO 81063, Position Type:
Full Time, Salary Range: $20.06 - $25.07 Hourly, Join Our Team at Valley-Wide Health Systems, Inc.

• 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.

• 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.

• 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.

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, support, coordination, or case management.

Skills:

• Strong customer service and interpersonal communication skills.
• Excellent critical thinking, organizational, and problem-solving abilities.
• Ability to prioritize multiple tasks and work effectively in a fast-paced healthcare environment.
• Proficiency in Microsoft Word, Excel, Outlook, and Electronic Health Record (EHR) systems.
• Knowledge of referral management, appointment scheduling, and insurance authorization processes preferred.
• Ability to communicate professionally in person, over the phone, and through electronic communication.
• Ability to collaborate effectively with providers, nursing staff, and interdisciplinary healthcare teams.
• Familiarity with community resources and patient assistance programs.
• Sensitivity to the needs of low-income, underserved, and diverse populations.
• Basic Life Support (BLS) certification/training will be provided upon employment.

Bilingual Spanish-speaking preferred but not required.

Valley-Wide Health Systems, Inc. is dedicated to providing high-quality, patient-centered healthcare to all individuals across our multi-county service area in southern Colorado. As a non-profit, Federally Qualified Health Center (FQHC), we offer premier primary and preventive care through our 34 service sites strategically located in rural communities.

• Free Health Insurance (additional plan…