Clinic Care Navigator

Description

The Clinic Care Navigator supports the practice by working with patients, families, providers, and staff to promote timely access to needed care, coaching patients, families, and caregivers to understand the patient’s care plan and self‑care management responsibilities, and engaging patients in participation in preventive care. The primary role of the Clinic Care Navigator is to support the work of the practice.

• Use case management processes to assure quality care is delivered to PHC patients, the patients’ families, and the patients’ caregivers in the most efficient and effective manner across the healthcare continuum.
• Apply the principles of comprehensive, community‑based, patient‑centered, developmentally appropriate, and culturally and linguistically appropriate care coordination.
• Engage patients, patients’ families, and their caregivers in understanding, setting, and monitoring patient self‑management care plans.
• Document each patient’s individualized care plan and care coordination in PHC’s EHR.
• Coordinate each patient’s care by facilitating patient, family, or other caregiver access to medical home providers, staff, and resources as needed by the patient.
• Develop and maintain relationships among patients, patients’ families, and the patients’ care team that support patients’ access to the medical home.
• Act as a primary contact point, advocate, and source of information for patients and the community partners that help treat them.
• Research, find, and link patients to resources, services, and support mechanisms for their care plans and self‑management needs.
• Provide timely communication with patients, make inquiries, execute follow‑up actions, and help to integrate information into the care plan.
• Assist the care team by helping to measure quality and implement quality improvement, as assigned.
• Participate in continuing professional growth through attendance at workshops and professional in‑services, as assigned.
• Attend and participate in organized functions of PHC and perform administrative duties as necessary.
• Demonstrate personal responsibility and respect for patients, patients’ families, and coworkers in professional appearance.
• Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi‑disciplinary teams.
• Other duties as assigned.

High school diploma

CCMA/CCMA/RMA/CNA or equivalent experience in care navigation field

2+ years in a clinical or care navigation setting.

None

• Self‑motivated, dependable, strong work ethic with a desire to learn.
• Strong time and project management skills.
• Ability to work effectively in a team environment.
• Experience with computer applications.
• Knowledgeable in the various clinical and non‑clinical workflows in a medical practice.
• Familiarity with medical terminology.
• Ability to apply critical thinking skills and make sound judgments both while performing daily responsibilities and throughout the patient’s continuum of care.
• Ability to work successfully in a fast‑paced, stressful environment.
• Ability to work with a registry and an electronic health record.
• Empathy, mental alertness, precision, analytical problem‑solving abilities, communication skills, focus, and initiative.
• Effective oral and written communication skills.
• Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management.

• Talking, hearing, repetitive motions and close visual acuity associated with a normal office environment.
• Potential for a variety of exposure to additional work settings to include clinical/medical office, patient’s home, and/or a community‑based environment.
• The Clinic Care Navigator will work within an office setting unless limited flexibility is directed by a Supervisor. Any remote assigned work must occur within a home office space that is of low distraction, HIPAA compliant, and supported by a reliable internet service to support system applications.

• Standing, sitting for long periods while doing computer input and making phone calls.
• Must have ability to bend, stoop, twist and work with computer equipment.
• Stress involved in working with patients with multiple co‑morbidities and multiple assignments.