Care Navigator - Upward Health : Job Details

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person. It's no wonder 98% of patients report being fully satisfied with Upward Health!WHY IS THIS ROLE CRITICAL?The Care Team is a multidisciplinary team of licensed and unlicensed staff who provide direct support and care to Upward Health's patients. The Care Team is comprised of a diverse team that may include registered nurses, licensed social workers, pharmacists, therapists and paramedics, care navigators and care specialists. This team works within the community and in the patients' homes or meet in agreed upon locations in the community.The Care Navigator is responsible for ensuring a seamless patient experience as the single point of contact for the patient. The ideal candidate possesses career experiences in fast-paced provider office settings. Care Team staff are trained to provide extensive patient support and assistance. The Care Navigator offers a range of direct patient care support that includes community and medical referral aid, telephonic care coordination assistance to patients and providers, and clinical coordination across all medical and behavioral providers. Additionally, the Care Navigator assists the Care Team in utilization management. KEY RESPONSIBILITIES:Single point of contactCoordinate with providers and Care Team members to provide ongoing support and communication to our patients and ensure a smooth continuum of careMonitor patient hospitalizations and follow up as necessary with Care Team staffProvide patients with educational materials and execute correspondence to primary care physicians and specialists for new patient enrollments/appointmentsCollect, verify, & coordinate clinical and administrative information (e.g., Hospitalizations, Insurance)Patient registrationPerform outbound calls to patients to understand their clinical needs and connect them with appropriate resourcesCollect, enter, and/or confirm patient demographic, health, insurance, and payment information in EHR and related systemsHelp patients register for and access the EHR patient portalExplain Upward Health's payment policy to patientFacilitate completion of new patient formsInsurance verification and authorization fulfillmentVerify patient insurance information using insurance card and payers' portalsContact payers for out-of-network inquires and to determine coverage policiesIdentify patient cost-sharing amount and enter in EHR and related systemsIdentify and complete prior authorizations for services and medicationsMonitor insurance changes and identify/research established patients who lose eligibility Scheduling & check-inEnsure that patient appointments with Upward Health providers are scheduled promptly and efficientlyManage patient appointment cancelation and rescheduling as neededEnsure patient missed appointments are rescheduled and communicated to the physician/clinician, patient, and members of the Care TeamMaintain system of notifications sent to patients about scheduled appointmentsAttach any pre-visit paperwork to the patient's EHR chartEnsure completion of as-needed patient clinical and administrative forms ahead of visitsContact patient in advance of or at beginning of appointment to complete check-in and:Confirm demographic informationConfirm patient insurance eligibilityReview patient account balance and any co-payments dueCollect payment information from patients, including processing credit card payments for patient cost-sharing amountsNotify patients of necessary future appointment details Provide minor technical assistance to ensure that patients can access virtual visitsFollow Up Support from Provider VisitsAssistant the providers delivering care as it relates to pre and post visit documentation, following up on orders, faxes, and labs, and ensuring smooth experience for patient and providerPerform outbound calls to providers to make appointment for patients or follow up on careFollow up with patients to ensure their needs are met and schedule future wellness discussionsExpedite follow up to further coordinate next steps as to the patient response, scheduling needs and insurance coordinationVarious administrative support and other dutiesLead the answering of the phone and responding to the fax machine for patient inquiresAnswer inbound calls from patients, providers, and Upward Health resources as necessaryCollaborate with Finance colleagues on patient billing issuesHandle medical record requestsManage the incoming queue of patient referrals Prepare reports and documents as needed or requested, ensures Care Team is following proper documentation protocols at the direction of the ManagerAttend regular team meetings and participate in clinical roundsMaintain patient, provider, & payer contact & referral InformationOther duties as assignedKNOWLEDGE, SKILLS & ABILITIES:Interpersonal savvy, with the demonstrated by the ability to interact with and influence people to establish trust and build strong relationshipsPractice an extreme sense of urgency and 'can-do' attitude required for a role at a start-up companyStrong organizational skills and ability to juggle multiple high-priority tasks and maintain a personal scheduleStrong attention to detail to ensure that work is completed accurately and completelyAbility to establish priorities and meet deadlinesFlexibility to change course and take on additional responsibilities as the business requires Ability to work independently within a virtual operating environment and as part of a teamExcellent oral and written communication skillsAbility to exercise judgment in the application of professional servicesComfortable with computer data entryMulti-lingual capabilities preferred, but not required QUALIFICATIONS:3+ years at an outpatient healthcare practice serving as a patient representative or similar experienceHigh school graduate or GED requiredPrior experience in health insurance and medical terminology is preferredKnowledge of community resources in applicable geographic areaAble to maintain clear professional boundaries with members and coworkersCultural competency - able to work with diverse groups of community membersHighly technologically savvyReport development from clinical and non-clinical systemsAbility to assist with development and distribution of educational materialsUpward Health is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Compensation details: 22-24 Hourly WagePIa2cdbe3287e2-25660-#######2