Patient Navigator - Population Health

Minimum Qualifications

• Bachelor’s degree in Healthcare Management, Public Health, or other related field OR;
• Associate’s degree in Healthcare Management, Public Health or other related field AND two (2) years of experience directly related to the duties and responsibilities specified;
• High school diploma or equivalent AND four (4) years of experience directly related to the duties and responsibilities specified.

• Bachelor’s degree in Healthcare Management or Public Health.

• Three (3) years’ experience in the healthcare field. One (1) year of experience in statistical data analysis.

• Establishes close relationships with and serves as primary point of contact for patients.
• Strategizes to help find payor population based on regional payer mix by collecting and analyzing market data. Responsible for verifying insurance benefits and ensuring coverage for obesity treatment for patients.
• Maintains a working knowledge of insurance payors pre-certification requirements for medications, diagnostic testing, surgery, referrals, etc.; proactively reviews policies for changes to prevent delays in certification where applicable.
• Educates providers and staff on payor regulations to prevent denials.
• Removes barriers to care by identifying resources for patients and helping them navigate through healthcare services.
• Works with different service lines to assure coordination of appointments if applicable.
• Schedules patient appointments and adjusts as needed, including coordinating appointments with laboratory or diagnostic testing, ensuring adherence to appointments, reminder calls, and managing the patient wait‑list.
• Guesses when an assigned patient is admitted and rounds on them daily/assists with scheduling discharge appointments.
• Assists with getting prescriptions filled; assesses cost, availability, etc.
• Documents patient information and obtains outside records as needed.
• Engages family and/or community resources to meet the identified emotional, social, and financial needs of the patient.
• Collaborates with available social services for appropriate resource and financial management, including financial assistance coordination and referrals, entitlement program coordination and referrals, patient benefit coordination, assessment for appropriate usage of healthcare resources, and clinical cost efficiency.
• Other department‑specific duties may be assigned.

• Ability to sit for extended periods of time.

• Standard office/clinical environment.

• Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, providers, and healthcare team colleagues.
• Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open‑minded, and adaptable to change.
• Proficient in Microsoft Office.

Scheduled Weekly

Hours:

40 hours per week.

Shift: Day (United States of America).

Exempt/Non‑Exempt:
United States of America (Non‑Exempt).

Company: SYSTEM West Virginia University Health System.

Cost Center: 415 SYSTEM Population Health Management.

Mid‑Senior level.

Full‑time.

Other, Information Technology, and Management.

Hospitals and Health Care.