Patient Navigator-

Job Description

REQUIREMENTS

Education

• High School Diploma or G.E.D required.
• Associate’s degree from an accredited college or university with major coursework in healthcare, social work, business administration, liberal arts, or related field preferred.
• Preferred training or certification as a Medical Assistant, Social Worker, Community Health Worker, Patient Navigator, EMT or other healthcare related certifications and experience.

Experience

• Minimum of two years’ experience in customer service, healthcare navigation, or patient support required.
• Experience in care coordination, community resources, or healthcare access preferred.

RESPONSIBILITES

Service Functions – Support patients in navigating care pathways and accessing services while ensuring adherence to departmental and corporate policies and procedures:

• Connect with patients by phone, SMS, email, or IVR and quickly develop rapport to encourage engagement in care.
• Provide live member support, including appointment scheduling, transportation coordination, and medical record transfer.
• Offer basic clinical education and appointment preparation support.
• Screen for social determinants of health (SDOH) and make referrals to community resources and payer ecosystems.
• Transfer calls requiring licensed clinical support to the 24/7 nurse line or appropriate internal resources.
• Verify/collect appropriate demographic information and update in appropriate system.
• Follow up with patients, providers, and partners to ensure timely access to services and adherence to established policies.
• Exercise exceptional customer service skills in an effort to optimize each patient interaction.
• Ensure that all patient interactions comply with HIPAA and other applicable federal/state laws.

Research Assistance – Assist in resolving navigation and care coordination issues by identifying barriers and researching in a timely manner:

• Track patient needs through to resolution, documenting all interactions thoroughly.
• Continuously evaluate status of open cases, prioritizing tasks to provide timely, high-quality support.
• Monitor issue trends and escalate patterns to supervisor for improvements in service delivery.

Team Interfaces/Customer Service – Establish and maintain professional relationships with internal/external partners, team members, and department contacts:

• Cooperate with team members to meet goals and complete tasks.
• Provide quality service that exceeds patient expectations.
• Treat all internal/external stakeholders with dignity and respect.
• Escalate to supervisor any situation outside the employee’s control that could adversely impact services.
• Act as mentor for new team members.
• Assist in user acceptance testing for system updates and enhancements.
• Participate in departmental improvement projects.

Are you interested in this position?

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