Care Navigator Position Available In Orleans, Louisiana

Job Description:

Upward Health is an in-home, multidisciplinary medical groupproviding 24/7 whole-person care. Our clinical team treatsphysical, behavioral, and social health needs when and where apatient needs help. Everyone on our team from our doctors, nurses,and Care Specialists to our HR, Technology, and Business Servicesstaff are driven by a desire to improve the lives of our patients.

We are able to treat a wide range of needs – everything fromaddressing poorly controlled blood sugar to combatting anxiety toaccessing medically tailored meals – because we know that healthrequires care for the whole person. It’s no wonder 98% of patientsreport being fully satisfied with Upward Health!

WHY IS THIS ROLECRITICAL

?The Care Team is a multidisciplinary team of licensed andunlicensed staff who provide direct support and care to UpwardHealth’s patients. The Care Team is comprised of a diverse teamthat may include registered nurses, licensed social workers,pharmacists, therapists and paramedics, care navigators and carespecialists. This team works within the community and in thepatients’ homes or meet in agreed upon locations in thecommunity.

The Care Navigator is responsible for ensuring a seamlesspatient experience as the single point of contact for the patient.

The ideal candidate possesses career experiences in fast-pacedprovider office settings. Care Team staff are trained to provideextensive patient support and assistance. The Care Navigator offersa range of direct patient care support that includes community andmedical referral aid, telephonic care coordination assistance topatients and providers, and clinical coordination across allmedical and behavioral providers. Additionally, the Care Navigatorassists the Care Team in utilization management.

KEYRESPONSIBILITIES

Single point of contact Coordinate with providers and Care Team members to provideongoing support and communication to our patients and ensure asmooth continuum of care Monitor patient hospitalizations and follow up as necessarywith Care Team staff Provide patients with educational materials and executecorrespondence to primary care physicians and specialists for newpatient enrollments/appointments Collect, verify, & coordinate clinical and administrativeinformation (e.g., Hospitalizations, Insurance) Patient registration Perform outbound calls to patients to understand their clinicalneeds and connect them with appropriate resources Collect, enter, and/or confirm patient demographic, health,insurance, and payment information in EHR and related systems Help patients register for and access the EHR patientportal Explain Upward Health’s payment policy to patient Facilitate completion of new patient forms Insurance verification and authorization fulfillment Verify patient insurance information using insurance card andpayers’ portals Contact payers for out-of-network inquires and to determinecoverage policies Identify patient cost-sharing amount and enter in EHR andrelated systems Identify and complete prior authorizations for services andmedications Monitor insurance changes and identify/research establishedpatients who lose eligibility Scheduling & check-in Ensure that patient appointments with Upward Health providersare scheduled promptly and efficiently Manage patient appointment cancelation and rescheduling asneeded Ensure patient missed appointments are rescheduled andcommunicated to the physician/clinician, patient, and members ofthe Care Team Maintain system of notifications sent to patients aboutscheduled appointments Attach any pre-visit paperwork to the patient’s EHR chart Ensure completion of as-needed patient clinical andadministrative forms ahead of visits Contact patient in advance of or at beginning of appointment tocomplete check-in and: Confirm demographic information Confirm patient insurance eligibility Review patient account balance and any co-payments due Collect payment information from patients, including processingcredit card payments for patient cost-sharing amounts Notify patients of necessary future appointment details Provide minor technical assistance to ensure that patients canaccess virtual visits Follow Up Support from Provider Visits Assistant the providers delivering care as it relates to preand post visit documentation, following up on orders, faxes, andlabs, and ensuring smooth experience for patient and provider Perform outbound calls to providers to make appointment forpatients or follow up on care Follow up with patients to ensure their needs are met andschedule future wellness discussions Expedite follow up to further coordinate next steps as to thepatient response, scheduling needs and insurance coordination Various administrative support and other duties Lead the answering of the phone and responding to the faxmachine for patient inquires Answer inbound calls from patients, providers, and UpwardHealth resources as necessary Collaborate with Finance colleagues on patient billingissues Handle medical record requests Manage the incoming queue of patient referrals Prepare reports and documents as needed or requested, ensuresCare Team is following proper documentation protocols at thedirection of the Manager Attend regular team meetings and participate in clinicalrounds Maintain patient, provider, & payer contact & referralInformation Other duties as assigned

KNOWLEDGE, SKILLS & ABILITIES

Interpersonal savvy, with the demonstrated by the ability tointeract with and influence people to establish trust and buildstrong relationships Practice an extreme sense of urgency and ‘can-do’ attituderequired for a role at a start-up company Strong organizational skills and ability to juggle multiplehigh-priority tasks and maintain a personal schedule Strong attention to detail to ensure that work is completedaccurately and completely Ability to establish priorities and meet deadlines Flexibility to change course and take on additionalresponsibilities as the business requires Ability to work independently within a virtual operatingenvironment and as part of a team Excellent oral and written communication skills Ability to exercise judgment in the application of professionalservices Comfortable with computer data entry Multi-lingual capabilities preferred, but not required

QUALIFICATIONS

3+ years at an outpatient healthcare practice serving as apatient representative or similar experience High school graduate or GED required Prior experience in health insurance and medical terminology ispreferred Knowledge of community resources in applicable geographicarea Able to maintain clear professional boundaries with members andcoworkers Cultural competency – able to work with diverse groups ofcommunity members Highly technologically savvy Report development from clinical and non-clinical systems Ability to assist with development and distribution ofeducational materialsUpward Health is proud to be an equalopportunity/affirmative action employer. We are committed toattracting, retaining, and maximizing the performance of a diverseand inclusive workforce. This job description is a general outlineof duties performed and is not to be misconstrued as encompassingall duties performed within the position.

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