Patient Care Navigator

3 weeks ago


Miami, United States Genuine Health Group LLC Full time
Job DescriptionJob DescriptionSummary

The Patient Care Navigator is an administrative position that works with the clinical team. The Patient Care Navigator facilitates delivery of information to individual members of the clinical team to help coordinate prescribed healthcare services. Patient Care Navigators are liaisons between beneficiaries/members and healthcare components. In addition, the Patient Care Navigators’ role is to help patients understand treatment plans. Through beneficiary/ member contact, Patient Care Navigators will assist in identifying care gaps in patient care by tracking ordered wellness visits, chronic care management and transition care services. Navigators will report to the Clinical Operations Manager. Patient Care Navigators will not recommend or render any medical services.

Essential Duties and Responsibilities
  • Increases involvement of the beneficiary/member and or their caregiver in the decision-making process.
  • Minimizes fragmentation of care within the healthcare delivery system.
  • Assists in improving adherence to the plan of care for the beneficiary.
  • Assists beneficiary/member by acting as an advocate.
  • Collaborates with clinical teams to focus on moving the beneficiary/member to self-care (independence) whenever possible.
  • Assists in coordinating care for beneficiary/member, including chronic care management and transition care management.
  • Participates in team meetings and quality improvement initiative.
  • Focuses on transitions of care, which includes a complete transfer from one care setting to the next that is safe, effective, and timely.
  • Collaborates with outpatient staff to ensure that safe transition to the new care setting and follow up with the primary care physician and/or specialist.
  • Improves outcomes by utilizing adherence guidelines, standardized tools, and proven processes to measure a beneficiary/member’s understanding and acceptance of the proposed plans, his/her willingness to change, and his/her support to maintain health behavior change.
  • Facilitates health and disease beneficiary/member education.
  • Coordinates with clinical teams with the goal of moving beneficiary to optimal levels of health and well-being.
  • Improves beneficiary/member safety and satisfaction with their healthcare needs.
  • Expands the interdisciplinary team to include beneficiary/member and or their identified support system, healthcare providers; including community based and facility-based professionals (i.e. pharmacists, Medical Social Workers, holistic care providers).
  • Improves beneficiary/member experience by coordinating appointments and referrals with specialists using our Preferred Provider Network.
  • Maintains a daily census of beneficiaries/members’ admissions, discharge dispositions.
  • Demonstrates proficiency with electronic medical records and care coordination systems.
  • Documents all interactions between beneficiary/member/ caregiver and all components of the healthcare delivery system.
  • Adheres to all policies and procedures including but not limited to the HIPAA Privacy rule.
  • Performs other duties as assigned.
Knowledge, Skills and Abilities
  • Knowledge with Care Coordination of the elderly.
  • Ability to work with a high attention to detail.
  • Compassion and empathy.
  • Strong communication and interpersonal skills; both written and oral.
  • Proficiency with electronic healthcare records systems.
  • Proficiency in Excel and Word.
Minimum Education and Experience Position Requirements:
  • Education

- High School diploma

- Driver’s license

  • Experience

- Preferred One (1) year of outpatient or inpatient care setting experience

  • Language

- Fully bilingual preferred (English/Spanish)




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