Population Health Patient Navigator

3 weeks ago

Gastonia, United States Kintegra Health Full time
Job DescriptionJob Description

Title: Population Health Patient Navigator

Department: Population Health & Case Management

Status: Hourly

Position: Classification/Category: Clinical

Location: Coverage & Support for All Medical Sites

Reports To: Director of Population Health & Case Management

Direct Reports: None

Summary of Position:


The Population Health Patient Navigator supports care management services for Kintegra patients. The Patient Navigator will provide individualized assistance to facilitate access to quality care.


The Patient Navigator will provide patients with resources to improve their health by identifying and providing access to providers, health education services, community resources, and social support services to address their individual needs.


The Patient Navigator will work closely with panel managers, clinical sites, providers, contracted programs, and patients to align our initiatives and goals.


Minimum Qualifications and Required Skills

  • Medical Assistant (preferred from an accredited program), Certified Nursing Assistant II, Community Health Worker, or with 3-5 years relevant work experience.
  • Bilingual preferred
  • Excellent interpersonal communication skills.
  • Strong organizational, analytical, and time management skills.
  • Strong computer skills/ Data Entry/ EHR documentation and reporting/Utilization of Microsoft Office Suite application
  • Clinical competence in disease management and care management principles.
  • Competence is establishing rapport with a client and providers.
  • Ability to work independently as well as be a team player.
  • Knowledge of and compliance with federal and state regulations applicable to the position.


Key Responsibilities:

  • Provide patients receiving case management with access and referral to resources to address their needs, including patient education on chronic disease management and referral to internal Kintegra Health programs available to uninsured patients (MAT, dental, eye clinic, endocrinology, diabetes education, Hepatitis C, HealthNet Gaston, etc.).
  • Use motivational interviewing techniques to engage patients and sustain engagement.
  • Assess patients’ barriers to care and resources and assist them with devising solutions to decrease or eliminate those barriers.
  • Follow up with patients to ensure resources have been secured and appointments have been kept.
  • Provide education and support to encourage patients to use the health care system appropriately.
  • Reassesses patients to evaluate changes needed to the treatment plan.
  • Support the Population Health Team in achieving Clinically Integrated network initiatives (Annual Wellness Visits, patient outreach, linkage to resources, medication adherence, Advance Directives, Transition of Care, etc.)
  • Refer patients to the Population Health Team member (Nursing staff) for issues that fall outside the scope/licensure of the Patient Navigator.
  • Interpersonal Skills/ Build and Maintain working relationships.
  • Understanding of the cultural and socioeconomic backgrounds in the community
  • Ability to establish effective, trusting working relationships with patients.
  • Perform other duties as assigned.


Physical Demands

  • Work in an open office environment, clinical sites and work remotely.
  • Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds.
  • Prolonged periods of sitting, reading, and documentation are required.

Kintegra Health Core Requirements

  1. Patient First – An approach to care that holds primary, the well-being and desires of the patient
  2. Build not Blame – Focusing first on finding fault with the process rather than the person
  3. Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers
  4. Cooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description
  5. Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.


Kintegra Health is a is a community sponsored, family-centered provider of health care, health education and preventive care services without regard to the ability to pay. We screen potential employees to first ensure alignment with our core requirements followed by the requisite position skills set. In doing so we need staff committed to this mission who do their best to live and work on the characteristics of our core values as we strive to care for ever increasing members of the communities we serve.


Our goals are:

  • To provide continuing comprehensive and accessible primary care services to individuals and families of all economic levels within the counties we serve.
  • To provide primary care services to meet the physical as well as social health needs of individuals and families, promoting health maintenance, providing timely diagnostics, treatment, and referral services.
  • To emphasize preventive care through patient and community education to help individuals become aware and responsible for their own health behaviors.
  • To employ an interdisciplinary team approach in collaboration with other community providers to provide a continuum of appropriate patient/family-oriented care in a cost-effective manner.

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