Patient Care Navigator

Job Details:

Job Location:

Center Dental Clinic - Center, CO, Position Type:
Full Time, Salary Range: $20.06 - $25.07

Hourly, 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.

• 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.

• 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.
• Pr…