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Patient Navigator

Administrative | San Francisco, CA | Full Time, Contract, and Temporary

Job Description

Patient Navigator 823080 

The Autism Program Navigator (APN) is responsible for establishing daily administrative workflows and managing these daily operations. The APN is responsible for pre-appointment and post -appointment coordination (e.g. scheduling, maintenance of staff schedules) with families. The APN coordinates with insurance companies to obtain information about patient benefits, obtain insurance authorizations, and follow-up patient insurance claims, if needed. APN communicates insurance coverage to patients and their families in order to support transparency of financial liability for services. The APN also coordinates patients moving between various services and programs. The APN is responsible for updating the STAR website to disseminate information about the STAR Center’s services and programs to existing and potential patients and families. The APN develops relevant content for posting on the website independently. Reporting to the Outpatient Practice Manager, this position is the first point of contact for the public as well as professionals. The APN is required to screen inquiries from the public, parents and families about the STAR services and programs in a professional, confidential and patient-centered manner. The APN is then responsible for presenting these inquiries to the clinical director to determine the appropriate course of action and then coordinating next steps as appropriate. Under the general supervision of the Outpatient Practice Manager it is expected that the APN will independently respond to common inquiries, problem solve and continually work to improve clinic processes.

Responsibilities:

  • Recommends changes or new processes to increase patient satisfaction in navigating across the healthcare system for services.
  • Addresses patient grievances at point of service. Identifies appropriate resource as needed. Investigates patient complaints and grievances about barriers (or perceived barriers) for patient satisfaction and communicates grievances to clinical and program directors.
  • Analyzes patient satisfaction reports and metrics to identify areas for improvement. Collaborates with managers and colleagues across the healthcare system to formulate and implement changes to processes and / or action plans.
  • Develops library of resources, and orientation information for patients. Provides new patients with an overview of resources and general information on billing, scheduling, and locating resources for clinical questions or concerns
  • Collects, evaluates and presents meaningful use and / or relevant operations data and metrics for leadership. Establishes recommendations for follow up and action plans for improvement.
  • Participates in medical center committees or task forces and other special projects as required to support improvements in the patient experience. Contributes to creating new marketing tools and follow-up surveys to increase patient awareness and positively impact overall business. May participate on teams for improvements in clinical applications, in conjunction with workflows.
  • Liaisons with departments (e.g., developmental behavioral pediatrics, child neurology or clinical genetics) to coordinate referral processes and support patient navigation services, proposes improvements to workflows; facilitates improved coordination of care based on each practice's scheduling requirements.
  • Anticipates and initiates coordination activities; provides road maps for patients to set expectations and coordinate care in alignment with patient's needs.
  • Clinic pre-appointment responsibilities. With a provided framework conduct brief intake with family in order to identify level of treatment/assessment needs, provide education to family regarding services offered at the STAR Center in order to determine appropriateness of fit, send clinical forms to families, collect previous assessment reports, develop and maintain clinical data base via RedCap, manage wait list and identify cases of high need to clinical director, schedule patients/clinicians, make reminder calls and manage incoming faxes and mailing with patient data. Maintain the confidentiality of all patients and subject related information in accordance with company policy/procedure.
  • Insurance authorizations. Responsible for requesting retro and pre authorization for each patient in the STAR Center. Authorization duties will primarily consist of pre-authorizations for psychological and neuropsychological testing and psychotherapy service. This position is responsible for obtaining authorization and sending in medical documentation. Communicate insurance coverage to patients. Manage wait list for patients and lead discussion with psychologists and physicians regarding the level of treatment needs for each patient.
  • Responsible for conducting analysis of billing and STAR parents/caregiver training service accounts and reimbursement items and/or other special projects directed by the Clinical Director. 
  • Gather payment and track patient liability for STAR parents/caregiver training services. Miscellaneous tasks as needed such as supervision of children during parent interviews and feedback sessions, manage assessment inventory and order new protocols and assessment kits when necessary.
  • Perform follow up calls to family, schedule additional appointments as necessary. Provide resources to family and education regarding community services when the center is not able to meet the families need. 
  • Manage intersection between various services and activities. For example, coordinating the referral to studies or in/out of treatment.
  • Develop content and maintain website material for the STAR Center.

Requirements:

  • Bachelor's degree in related area and / or equivalent experience / training.
  • Strong knowledge of Patient Rights & Responsibilities, Joint Commission standards, and Centers for Medicare / Medicaid regulations. Knowledge of Medical Terminology. Strong knowledge of data collection, compilation, and analytical techniques.
  • Strong skills to comprehend and assess patient's grievances to quickly locate appropriate resource for assistance. In-depth knowledge of the organization and how to get issues resolved.
  • Strong interpersonal and customer service skills. Ability to communicate and resolve issues effectively with a diverse population of patients, staff and physicians.
  • Excellent analytical and problem-solving skills. Ability to develop solutions and recommend changes and follow through with implementation.
  • Excellent written and verbal communication skills.
  • Proficiency with Windows-based software including Microsoft word, Excel, Outlook. Knowledge of computer systems and software used in functional area.
  • Proficiency of RedCap in order track patient lists and manage clinician caseloads
  • Proficiency in Apex

$28 per hour            San Francisco, CA 94143            7 Month Assignment