Aug 29, 2019

Patient Navigator Coordinator II, Full Time, Norwood

  • Professional Diversity Network
  • Norwood, MA, USA
Full-Time Administration

Job Description

Atrius Health

Atrius Health is a nonprofit healthcare leader delivering a system of connected care that enables us to know our patients better so that we can serve them well. Across 32 clinical locations, more than 50 specialties and 825 physicians, we provide proactive, customized care to more than 720,000 adult and pediatric patients across eastern Massachusetts.


The Atrius Health practices including Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates and PMG Physician Associates - together with VNA Care - work in collaboration with hospital partners, community specialists and skilled nursing facilities, to develop innovative and effective ways of delivering care in the most appropriate setting, making it easier for patients to be healthy.


We believe that by establishing a solid foundation of knowledge, understanding and trust with each of our patients, we enrich their health and enhance their lives.

SUMMARY

Reporting to and working under the general direction of the Supervisor(s) and Manager of the department, reviews complex referral requests and evaluates and assigns appropriate specialist for the patient. Works with patients and providers to understand services being requested. Interviews patients as needed to obtain full understanding of what information is being requested. Works closely with Specialty Nurses to ensure clinical handoffs are safe and appropriate. Coordinates care both within Atrius Health and with external partners.

GENERAL DUTIES AND RESPONSIBILITIES

  • Reviews referral information from work queue for pertinent information regarding referral requests. Reviews each external referral for opportunity to convert to internal referral and reviews options with patients.

  • Redirects patients with managed care products appropriately ensuring clinical handoff is safe using expertise of specialty nurses. Ensures adequate information is obtained and relayed when care is moved.

  • Explains insurance benefits and options to patients. Explains denials to patients.

  • Promotes the Atrius Health System of Care by highlighting internal providers and their expertise.

  • Works with supervisors to ensure patients are receiving timely responses and detailed answers to their complex questions.

  • Researches questions/concerns from patients regarding billing and determines if issue is related to the referral process. Assists in resolving billing and denied referral matters as they relate to the referral process.

  • Receives escalated issues and stat same day calls; determine appropriate action and/or works with clinical team for decision.

  • Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed.

  • Supports roles within the Navigator. Trains and teaches as needed.

  • Participates in problem solving activities, focusing on productivity and quality. Works with supervisors to ensure continuous improvement of the department.


EDUCATION/LICENSES/CERTIFICATIONS

A minimum of a High school diploma (or equivalent education, experience or training) is required.

EXPERIENCE

A minimum of three years in a clinical or customer service setting preferred. Must be able to respond knowledgeably to a wide range of patient issues for every contracted and non-contracted payers, including government and non-government payers. Strong technical proficiency in Microsoft, scheduling software and electronic medical records systems (Epic or equivalent). Strong problem solving and complex patient management skills preferred. Relevant experience in the managed care environment preferred. High level of understanding of health insurance products and limitations in order to match patient to available providers.

SKILLS
  • Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

  • Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.

  • Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

  • Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

  • Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

  • Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

  • Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.

  • Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members

Atrius Health is committed to a policy of non-discrimination and equal employment opportunity. All patients, employees, applicants, and other constituents of Atrius Health will be treated with respect and dignity regardless of race, national origin, gender, age, religion, disability, veteran status, marital/domestic partner status, parental status, sexual orientation and gender identity and/or expression, or other dimensions of diversity.

Excellent benefits Include:

* Up to 8% company retirement contribution,

* Generous Paid Time Off

* 10 paid holidays,

* Paid professional development,

* Competitive health and welfare benefit package.

Atrius Health is an equal opportunity/affirmative action employer and does not discriminate in recruiting, hiring, training, promoting or any other employment practices on the basis of race, color, religion, sex, marital status, age, sexual orientation, gender identity, national origin, military service or application for military service, veteran or disability status.

Applicants have rights under Federal Employment Laws: Family and Medical Leave Act (FMLA);Equal Employment Opportunity (EEO); and Employee Polygraph Protection Act (EPPA).

VEVRAA Federal Contractor

Request Priority Protected Veteran & Disabled Referrals for all of our locations within the state

States

MA  

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