Care Management Navigator

Job Description

Job Summary 

Responsible for improving patient’s level of engagement, overall experience with acute and post-acute care services and ensuring appropriate utilization of in-network health system services. Care Management Navigator is responsible for ensuring effective coordination of healthcare services from both the acute and post-acute care settings, bridging care and communication with the patient’s primary care physician post-discharge and actively engaging the patient in overall healthcare management. The role of the Care Management Navigator is crucial to increasing patient engagement and establishing a continuum of care, increasing in-network utilization and the improvement of value based and publicly reported scoring.

Essential Functions

• Works in a medical setting with physician practices, hospital teams, Post-Acute Care Providers and the ACO to manage the full continuum of care in the provider network.
• Understanding of the clinical capabilities of Post- Acute Care Providers to assist patients and families in the event secondary placement decisions must be made.
• Provides assistance to the patient in establishing a PCP and scheduling of post-discharge appointments.
• Effectively utilizes care coordination and tracking software to understand and influence readmission factors and utilization patterns.
• Review patient care concerns and identify resolution of issues to meet patient care needs.
• Provide weekly reporting to Continuum of Care Coordinator on activity with Case Management, ED, Nursing and the Post-Acute Care Network.
• Documents interactions with patient, family hospital staff, and providers in accordance with the facility-specific documentation policies.

Qualifications

• Associate Degree in Education, Healthcare Administration, or a related field required
• Experience in a hospital or healthcare setting preferred

Knowledge, Skills and Abilities

• Strong organizational skills to manage schedules, records, and multiple priorities.
• Effective communication and interpersonal skills for engaging with students and staff.
• Familiarity with credentialing, compliance, and regulatory requirements for clinical placements.
• Proficiency in Microsoft Office Suite and hospital information systems or similar software.