Patient Navigator II (Bariatric Surgery, FT, 40 Hours, Days)
- Location: Boston, MA
- Posted: May 22, 2019
The Patient Navigator for Bariatric Surgery coordinates all administrative aspects of care for patients interested in weight loss surgery. The Patient Navigator is a primary resource for all patient/families and referring providers and is knowledgeable about scheduling and insurance guidelines for patient seminars, surgical visits, medical nutrition visits, support groups, and psychology visits. The Patient Navigator must handle all communications with superior customer service skills and with sensitivity to the patients needs.
The Patient Navigator manages the patient tracking database and is responsible for entering all patient demographic and appointment information into the system. Additionally, the Patient Navigator is responsible for running routine and ad-hoc reports to facilitate efficient patient tracking and to optimize the programs capacity.ESSENTIAL RESPONSIBILITIES / DUTIES:
Assessment & Planning
Works closely with the Program Coordinator and clinical staff to identify patients appropriate for participation in the WLS program.
Reaches out (via fax, phone calls, Epic Inbasket and referral portal) to all new patients referred to introduce program and schedule initial visits.
Reviews medical information and coordinates with the medical team to understand each patients needs.
Based on assessment, plans and implements a planning schedule appropriately and in a timely manner including the patient/family/significant other whenever possible.
Identifies cultural/ religious needs, language barriers, developmental needs, transportation, etc. and modifies plan of care as necessary to accommodate these needs.
Serves as a central contact for referring physicians & clinics, answering questions regarding the program and procedures.
Offers patient educational materials in language appropriate for the patient. Ensures education materials are available in the various clinics involved in referring patients for screening and treatment.
Ensures that patients understand the instructions for preparing for procedures, especially Bariatric surgery. Educates patients on the importance of maintaining appointments and program adherence.
Coordinates support groups and educational sessions.
Assists Physician Assistant and Program Coordinator with in-services training related to Bariatric surgery.
Processes all referrals and requests for new patient appointments received via telephone, fax or electronically. Schedules patients for new patient seminars.
Upon completion of the patient seminar, schedules all necessary patient appointments including surgical consult, medical nutrition, psychology, pre-op, and post-op visits.
Completes reminder calls for all patient appointments and new patient seminars.
Contacts all patients who did not attend a scheduled appointment, counsels the patient on the importance of keeping appointments and works with the patient to reschedule the appointment.
Coordinates with administrative staff in the clinical practice, medical nutrition, and psychology to ensure necessary information and documentation is available at the time of the appointment.
Patient Tracking & Database Management
Upon initial patient contact, accurately enters all necessary information, including but not limited to, patient demographics and date of scheduled patient seminar, into the patient tracking database
Works with the Program Coordinator to enter all appointment information (including cancellations, no-shows, reschedules) and applicable notes into the patient tracking database in a timely manner
Enters pertinent insurance information into the patient tracking database.
Track new patients progress through the program and provide reports on progress and outcomes. Runs routine and ad-hoc reports from the patient tracking database in order to effectively maximize program resources, and proactively identify opportunities for improvement
Proactively contact patients to resolve potential issues.
Verifies eligibility and benefits prior to initial consult and communicates any potential issues to the patient.
Works cooperatively with providers to process referrals for patients. Accurately documents approval number, number of visits authorized, and type of service approved in the hospital registration system. Completes the paperwork for referral authorizations and submits to the appropriate managed care organization in a timely manner.
Prospectively identifies patients who require authorization and obtain appropriate provider approval prior to the appointment date. Effectively communicates alternatives to patient if service is denied.
Refers self-pay patients or patients with insurance issues to Patient Financial Services, as appropriate. Partners with Patient Financial Services to effectively communicate to the patient alternative payment options and/or insurance issues.
Other Administrative Duties
Promptly and courteously answers telephone calls.
Communicates with all members of staff on work related issues effectively and courteously.
Assures that all messages for physicians and designees are accurate and forwarded to the appropriate individual promptly.
Analyses problems in order to determine appropriate course of action and offers constructive suggestions to improve efficiency in practice operations.
Assists with special projects as required
Attends and participates in meetings or committees as requested.
Performs manual clinic scheduling and registration functions using accepted downtime procedures
Contacts the ITS Help Desk to report faulty systems or hardware
Organizes work area for efficiency, neatness and safety
Collect co-payments and/or other patient payments at the time of service
Check-in patients and schedule follow-up appointments during clinic sessions
Perform other duties, as needed
Minimum of an Associates degree (or equivalent combination of formal education and experience) plus 1 year related experience (will consider equivalent combination of formal education and experience, i.e. HS/GED plus 3 years related experience). Bachelors degree desirable.
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
(See above under educational requirements). Related experience must be in the healthcare, patient navigation, human services and/or managed care.
KNOWLEDGE AND SKILLS:
Working knowledge of managed care- overall understanding of HMO, PPO and others; proficient knowledge of process of obtaining insurance approvals and referrals.
Proficiency with standard Microsoft programs (i.e. MS Word, Excel, PowerPoint, Outlook) and web browsers.
Excellent English communication skills (verbal and written) required. Bilingual or multi-lingual skills appropriate to the patient population served (especially Spanish), are a big plus.
Business writing skills required.
Excellent professional demeanor. Must be able to work effectively with all levels of staff and management.
Excellent interpersonal and customer service skills. Must be able to show empathy and be courteous with customers.
Cultural sensitivity and comfort with a wide range of social, racial and ethnic populations.
Must be able to maintain confidentiality of all personal/health sensitive information.
- Full time