PATIENT CARE NAVIGATOR (FT DAYS)

The Patient Care Navigator at Riverside Healthcare provides essential administrative and clinical support to nurses, social workers, and the management team within the Population Health/Quality department. This role is pivotal in coordinating patient care and ensuring adherence to established care management processes and demonstrates flexibility with assignments within professional scope/duties/licensure. The Patient Care Navigator will work to enhance patient outcomes through effective communication, coordination, and support, extending beyond the Population Health program to various other areas of care.

Shift & FTE:

• Days (8:00AM - 4:30PM) | 1.0 FTE

Essential Duties

Patient Monitoring and Outreach:

• Daily monitoring of payer portals and reports to identify inpatient discharges, Emergency Room discharges, and other high-risk patients.
• Provide outreach and assistance to patients, facilitating care flows according to established policies and procedures.
• Conduct follow-up outreach to ensure patients attend scheduled appointments, including transitional care visits.

Documentation and Communication:

• Document all patient communication and related activities in the Epic system and payer portals as required.
• Monitor and review revenue, compliance, and communicate with Site Supervisors regarding appointment schedules.

Care Coordination:

• Collaborate with patients and interdisciplinary care teams to address barriers to adherence, including transportation, food insecurity, social services, and financial concerns.
• Act as a liaison to multiple departments, agencies, and provider offices, including but not limited to Loving Lift, inpatient social services, Home Health Care, Primary Care, and specialty clinics.

Quality and Compliance Management:

• Monitor, evaluate, and document monthly care management readmissions and utilization of Home Health Care, Mobile Integrated Health, and Loving Lift transportation.
• Identify, outreach, and follow up with patients to address gaps in preventative health maintenance and perform quality measure care gap outreach.

Patient Education and Support:

• Educate patients on managing their diagnoses effectively at home, such as COPD stoplight education.
• Serve as the primary point of contact for patients with chronic special needs or identified high-risk cases needing care management services.

Administrative Support:

• Mail, collect, scan, and assist customers in completing health risk assessments.
• Provide additional administrative support as needed.

Non-essential Duties

• Assist with other administrative duties as assigned.
• Participate in departmental meetings and contribute to process improvements.

Preferred Experience

• Strong written and verbal communication skills.
• Exceptional interpersonal skills with the ability to engage with patients and interdisciplinary teams effectively.
• Proven ability to multi-task and manage a diverse workload.
• Intermediate proficiency with Microsoft Office programs.
• Ability to function independently, organize tasks, and be self-motivated. 
• Previous experience in an ambulatory care setting.
• Experience with Electronic Medical Records (EMR) systems, Epic experience preferred.
• Bilingual skills highly desirable

Required Licensure/Education

• High School Diploma or GED required 

Preferred Education

• Associates degree preferred. 

Employee Health Requirements

Exposure/Sensory Requirements

Exposure to: 

• Chemicals: White out for correction of typing/writing corrections. 
• Video Display Terminals: Average 
• Blood and Body Fluids: Low risk 
• TB or Airborne Pathogens: Low risk. 

Sensory requirements (speech, vision, smell, hearing, touch):

• Speech: Required to communicate with physicians, hospital staff, and outside agencies. 
• Vision: Needed to perform chart review data, computer screen work, reading data and information. 
• Smell: NA 
• Hearing: Needed for telephone communication and communication with team members 
• Touch: Needed to write, computer entry, individual pages of chart for review. 

Activity/Lifting Requirements 

Percentage of time during the normal workday the employee is required to:

• Sit: 70% 
• Twist: 2% 
• Stand: 10% 
• Crawl: 0% 
• Walk: 9% 
• Kneel: 1% 
• Lift: 4% 
• Drive: 0% 
• Squat: 1% 
• Climb: 0% 
• Bend: 2% 
• Reach above shoulders: 1% 

The weight required to be lifted each normal workday according to the continuum described below:

• Up to 10 lbs: Not Required 
• Up to 20 lbs: Not Required 
• Up to 35 lbs: Not Required 
• Up to 50 lbs: Not Required 
• Up to 75 lbs: Not Required 
• Up to 100 lbs: Not Required 
• Over 100 lbs: Not Required 

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.): 

Maximum consecutive time (minutes) during the normal workday for each activity:

• Sit: 120 
• Twist: 1 
• Stand: 30 
• Crawl: 0 
• Walk: 10 
• Kneel: 1 
• Lift: 5 
• Drive: 0 
• Squat: 1 
• Climb: 0 
• Bend: 2 
• Reach above shoulders: 1 

Repetitive use of hands (Frequency indicated): 

• Simple grasp up to 10 lbs. 
• Normal weight: 80% 
• Pushing &pulling Normal weight: 
• Fine Manipulation: Computer entry, writing. 

Repetitive use of foot or feet in operating machine control: None 

Environmental Factors & Special Hazards

• Environmental Factors (Time Spent): 
• Inside hours: 8 
• Outside hours : 0 
• Temperature: Normal Range 
• Lighting: Average 
• Noise levels: Average 
• Humidity: Normal Range 
• Atmosphere: Odors, Dust 
• Special Hazards: NA 
• Protective Clothing Required: None