Job Title: Care Navigator FLSA Status: Non-Exempt Type: Part-time/Full-time Department: Operations Reports To: Project Leader/Regional Manager The CareThrough Care Navigator serves as an integral part of the medical care team to help empower and engage patients in their healthcare. While the Care Navigator's duties may vary dependent on clinical placement, the overarching purpose of this position is to collaborate with patients to provide education and care coordination to help them manage their medical conditions and health, while allowing medical providers to practice more effectively and efficiently. ESSENTIAL FUNCTIONS: Duties and Responsibilities may include: Apply the principles of comprehensive, community-based, patient-centered, developmentally appropriate, and culturally and linguistically sensitive care coordination services. Use case management processes to ensure quality care is delivered to the Practice's patients, families and caregivers in the most efficient and effective manner across the care continuum. Engage patients, families and their caregivers in understanding, establishing and monitoring patient self-management care plans, as appropriate, in a manner that is culturally and linguistically appropriate to the patient, family and caregiver. Document each patient's individualized care plan and care coordination in the Practice's database. Coordinate the patient's care by facilitating patient, family or caregiver access to medical home providers, employees and resources as needed by the patient. Conduct and document assessments of patient needs and resources for effective self-care management. Develop and maintain relationships among patients, families and caregivers, and the patient's care team. Communicate with and provide feedback to referral sources including physicians, advanced practice providers, behavioral health specialists, social services, employees and/or care coordinators as appropriate. Act as the primary contact point, advocate and source of information for patients, and the community partners who help treat them. Research, find, and link patients to resources, services and support mechanisms for their care plans and self-care management needs. Provide timely communication with patients as required Assist the care team by helping to measure quality and identify, refine and implement practice improvements Demonstrate personal responsibility and respect for patients, families, caregivers and co-workers in professional appearance. Demonstrate flexibility, enthusiasm and willingness to cooperate while working with others in multi-disciplinary teams with activities to include participating in daily huddles. Qualifications High School Degree (Required), College Degree (Preferred) One year experience in Health Care industry encouraged. Well versed in the knowledge of chronic conditions including prevention, disease characteristics and health promotion efforts. Demonstrated skills in leadership, advocacy, communication, education and counseling. Culturally effective capabilities demonstrating a sensitivity and responsiveness to varying cultural characteristics and beliefs. Bilingual: English/Spanish, depending on location preferred. Exemplary work ethic and professionalism. Strong computer skills - technology savvy Skills and Abilities Ability to apply critical thinking skills and make sound judgments both while performing daily responsibilities and throughout the patient's continuum of care. Knowledge and demonstrated abilities to work in a regulatory climate that includes oversight by federal and state laws and contracts with insurance companies. Effective oral and written communication skills. Excellent interpersonal skills reflecting clarity and diplomacy; communicates accurately and effectively with all levels of employees and management. Detail oriented, thorough and able to handle multiple tasks and projects with varying deadlines and priorities. Ability to interpret and relay to patients, families and caregivers the applicable Medicare, Medicaid or private insurance coverage for ordered services to include information about coverage limits and any costs the patient may incur. Training Upon hiring, the Patient Care Navigator is expected to successfully complete the following online and in-person training requirements : Classroom Training Medicolegal documentation Medical facility workflow Efficiency management Medical terminology Pathophysiology Physical exam findings PHI/HIPAA/HITECH Payers and Payer Programs Evaluation and Management (E&M) billing basics ICD-10 documentation requirements Health Education Techniques and Practices - Demonstrate knowledge of Prochaska's stages of change model and the ability to apply Motivational Interviewing (MI) practices and the road map for Brief Negotiation (BN) Final Exam Clinical Training Initial competency assessment Facility-specific training Ongoing training and mentoring Environmental Working Conditions Ability to work successfully in a fast-paced, stressful environment, use good judgment and patience in all situations. Key success factors are empathy, mental alertness, precision, analytical problem-solving abilities, communication skills, focus, and initiative. May be required to lift or transfer from 10 to 100-plus pounds, and carry, reach, stoop, bend, crouch and kneel. May be exposed to mechanical and electrical equipment, explosives, burns, chemicals, fumes, gases, odors and toxic waste. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to stand for long periods of time Frequently required to stand, walk, sit, use hands, handle documents, bend and stoop as needed, and reach with hands and arms Required to use a keyboard and computer regularly Position Type/Expected Hours of Work This is a full-time or part-time position and hours of work and days vary Monday through Sunday depending on the facility contract and hours needed. Travel Travel may be required for this position between local hospitals and medical facilities, as required by the particular needs of the client. Other Duties Please note this job description is not designed to cover or contain comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. 3. QUALITY CONTROL CareThrough monitors the Patient Care Navigator job performance in the following manner: Quarterly performance evaluation of the Patient Care Navigator. Annual review of position responsibilities for employees and providers to identify and act upon opportunities to work to the top of licensure.
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