Job Abstract

The Patient Navigator will be responsible for patient/member outreach activities, including various campaigns related to improving the patient’s overall experience and compliance with office visits. This role is pivotal in guiding patients through their treatment journey. This role works as support to our Quality Assurance Specialist and will lead the remote patient monitoring program at UCHC.

• Interpret and comply with quality assurance standards.
• Ensure ongoing abidance by industry regulatory and quality requirements.
• Documenting and reporting product or service quality levels.
• Complete health risk assessments as necessary.
• Monitor IPA data reporting requirements and upload all data to various IPA and payor data portals.
• Monitor all payer portals and respond to all insurance-driven requests for data, working with the clinical team as necessary to complete data requests.
• Conduct random chart audits for the clinical team.
• Data entry, Answer, refer and/or follow-up via telephone, fax, email and mail with patient questions related to the program and specific needs of the patients. Triage to the appropriate Care team.
• Maintains accurate documentation in google sheets or tracking logs.
• Performs routine specialized procedures, such as setting up the iHealth products for the patients under established protocols.
• Manages clinic inventories and medical supplies.
• Educates and advises patients on specific medical issues within established parameters to include obtaining prescription information.
• Directs patient flow following provider schedules/patient appointments.
• Coordinates routine office activities and administrative functions to support clinic activities.
• Other duties as assigned by QI Director

Job Qualifications

• College degree preferred, but not required if candidate has relevant work experience.
• Previous experience in member services/community outreach capacity; knowledge of regulatory requirements.
• Good verbal communication skills, including ability to effectively communicate with internal and external customers
• Knack for implementation of corrective action programs.
• Experience in eCW pressed, but not required.
• Superb computer competence, including experience with databases and Microsoft Office.
• Knowledge of QA terms, tools, and methodologies.
• Bilingual (English & Spanish) preferred.