Patient Navigator
Listed on 2026-09-20
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Healthcare
Community Health, Patient/Health Advocate, Healthcare Administration, Health Education & Promotion
The Patient Navigator is a community health professional who provides field-based case management services to patients accessing Abortion care. This person is the main point of contact for abortion care services. The Patient Navigator builds strong relationships with patients in order to help them stay engaged in medical care and adhere to their guidance. The person in this position is committed to removing the patient’s barriers to care by identifying critical resources for clients, helping them navigate through health care services and systems, and promoting patient’s health.
They work closely with the Abortion Access team, which may include clinician, nurses, and other clinical staff to support positive patient health outcomes.
Reporting to the Director of Navigation Services and Patient Experience, the Patient Navigator delivers comprehensive care coordination, insurance enrollment support, financial advocacy, and medication access assistance for individuals seeking services such as medical abortion (MAB), gender-affirming hormone therapy (GAHT), PrEP/PEP, and a full range of reproductive and sexual health care. This position guides patients through complex healthcare systems, including NJ Family Care (Medicaid), Presumptive Eligibility, and the Health Insurance Marketplace, to ensure timely access to care.
The Patient Navigator also supports prior authorization and appeal processes, facilitates medication access, and connects patients with financial aid and community resources.
1. Guide patients through enrollment in public and private insurance programs, including NJ Family Care (Medicaid), Presumptive Eligibility, and Qualified Health Plans (QHPs) via NJ Get Covered, ensuring applications are accurate, thorough, and submitted on time.
2. Serve as a PE Provider and maintain certification as required.
3. Review and verify all applications and supporting documents for accuracy and completeness.
4. Assist patients with renewals, eligibility updates, and submission of required verifications.
5. Educate patients about insurance benefits, coverage limits, provider networks, plan tiers, and out-of-pocket costs to empower informed decision-making.
6. Serve as case manager for Presumptive Eligibility patients, conducting follow-ups to ensure continuity of coverage.
7. Provide navigation support to patients seeking medical abortion (MAB), gender-affirming hormone therapy (GAHT), PrEP/PEP, and comprehensive reproductive and sexual health services.
8. Coordinate appointments, referrals, laboratory services, transportation (such as Uber Health), and follow-up care as needed for patients.
9. Work collaboratively with clinical teams to remove barriers to care and ensure seamless service continuity.
10. Provide education regarding program eligibility, funding sources, and service coverage.
11. Ensures adherence with PPMNJ’s "Privacy Guidelines," HIPAA compliance program, and PPFA’s MS&Gs, where applicable.
12. Initiate, track, and follow up on prior authorizations for medications and services.
13. Address insurance denials by reviewing cases, assisting with appeals, and submitting required documentation.
14. Coordinate with pharmacies, healthcare providers, and insurance carriers to ensure timely access to prescribed medications for patients.
15. Assist patients in accessing manufacturer assistance programs, co-pay cards, grant funding, and other financial assistance programs.
16. Track and document outcomes related to medication access and resolution of insurance issues.
17. Collect program data as needed.
18. Assess patient eligibility for both internal and external funding opportunities.
19. Provide financial counseling regarding insurance coverage, anticipated…
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