Patient Navigator (Medical Assistant Program Completion Required)
Core
Provide outreach and support to ensure members have access to care, navigating them through healthcare and benefits while connecting provider networks and health plan operations.
Role type
Patient Navigator (Medical Assistant)
Builds
Coordinated care access for seniors and chronically ill members
Domain
Healthcare / Medicare Advantage / HMO
Deliverable
client delivery
Required skills
Medical assistant front and back office experience, care coordination, Medicare Advantage or HMO navigation, referrals and authorizations, high-volume inbound customer service, telemarketing, member outreach, escalation resolution, ICD-10 and CPT codes knowledge, computer proficiency
Preferred skills
Bilingual fluency in English and Spanish, Korean, or Vietnamese, specialized experience in escalation or resolution units
Technologies
None explicitly stated
Responsibilities
Conduct patient outreach for new, termed, and transitioned patients; Ensure member has access to PCP and specialists; Educate members on gaps in care and assist with scheduling; Serve as patient liaison addressing quality measures; Make patient welcome calls; Mail correspondence; Make appointments, reminders, and confirmations; Place regular outreaches; Prepare and follow through on patient flagpole/escalation communications; Communicate with PCP regarding member updates; Assist with obtaining medical records; Help with authorizations and referrals; Resolve incoming calls concerning eligibility, benefits, provider info, clinical, and pharmacy needs
Seniority
Individual Contributor