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Patient Navigator-Medicaid Specialist

1 month ago

Van Alstyne, United States Children's Home Healthcare Full time
Job DescriptionJob Description*THIS IS A NON-CLINICAL ROLE*

CLASSIFICATION: Hourly
RESPONSIBLE TO: Regional COO’s
JOB SUMMARY: Under direct and indirect supervision, the Patient Navigator works closely with the patient population of Children’s Home Healthcare (CHH) to improve health outcomes through navigation, education, resolution of barriers, and advocacy through the social determinants of health framework. Works with a multidisciplinary team including but not limited to healthcare providers, case managers, care coordinators, managed care organizations (MCO), Medicaid representatives for the state of Texas, and members of the Children’s organization.

QUALIFICATIONS:
1. High School diploma or GED, College Degree preferred.
2. One year experience directly related to duties and responsibilities specified.
3. Completed degree(s) from an accredited institution that are above the minimum education requirement may
be substituted for experience on a year for year bases.
4. Strong interpersonal and communication skills and the ability to work effectively with a wide range of
constituencies in a diverse community.
5. Ability to read, write and speak English proficiently
6. Knowledge of community agencies and resources including but not limited to payor sources
7. Ability to effectively interpret needs and act as an advocate for a specified client population.
8. Knowledge of available patient support programs, agencies and services.
9. Knowledge of social determinants of health.
10. Skill in the use of personal computers and related software applications.
11. Analytical and problem-solving skills.
12. Ability to communicate complex information in a manner easily understood by patients and their families.
13. Ability to work both independently and in a team environment.
14. Knowledge of advocacy principles and processes.
15. Skill in accessing internet information services.
16. Capable of working under stress and deadlines and maintaining professionalism, a team spirit and servant
leadership behaviors.
17. Ability to interface and serve as a liaison between patients, referrals sources, the state and MCOs.
18. Professional demeanor and appearance.
19. A valid driver’s license and a good driving record (as determined by the employer) is required for this
position.

ESSENTIAL FUNCTIONS
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential
functions.
1. Based on the needs of the patient, provides navigation across the continuum of care, including assisting with
MCO or Medicaid services, interfacing with providers (Physicians), Durable Medical Equipment (DME)
companies, and referral sources.
2. Assist patients and their families with accessing services designed to support a range of social determinants of
health.
3. Works closely with operational and clinical staff of CHH as well as patients and their family members to
navigate and address barriers to care.
4. Serve as an advocate for patients and their families.
5. Provides patients and their families with access to appropriate supports. Provides resources and information
to patients and their families through credible, evidence-based sources.
6. Supports patient-led decision-making and communication.
7. Provides accurate information and support appropriate to the patient/families with sensitivity to language and
cultural preferences.
8. Establishes, maintains, and updates files, databases, records, reports and/or documents. Maintains accurate
and complete patient files.
9. Participates in continuing professional development programs as appropriate.
10. May provide comfort and support to patients and families.
11. Performs miscellaneous job-related duties as assigned.
12. Travel as necessary between branches and locations.
13. Serves on/attends agency meetings, may serve on association committees, and represent agency on provider
advisory boards.

PHYSICAL REQUIREMENTS
1.Requires the mobility to work in an office environment.
1. Requires the ability to sit at desk for long periods of time and intermittently walk, stand, stoop, kneel, crouch,
and reach while performing office functions; use hands to finger, handle or feel objects, tools
2. Must be able to maintain effective audio-visual discrimination and perception needed for making observations,
communicating with others, reading, and writing, and operating office equipment.
3. Must be able to use a telephone to communicate verbally and a keyboard to communicate through written
means, to review information and enter/retrieve data, to see and read characters on a computer screen.
4. Requires average lifting up to 50 pounds.

POSITION TYPE/EXPECTED HOURS OF WORK
This is a full-time position. Standard days and hours of work are Monday through Friday, 9:00am to 5:00pm.

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