Care Navigator

About This Role

The Care Navigator coordinates patient care by managing a network of community medical specialists and referral processes. This role ensures continuity of care by processing referrals, maintaining directories, communicating with stakeholders, and troubleshooting issues for patients needing services outside initial clinics.

Responsibilities

• Process daily referrals to secondary care, including specialists, imaging, community resources, and employer benefits
• Maintain high-quality directories for specialists, community services, and employer benefits
• Communicate, track, and document referrals to ensure continuity of care using IT databases
• Ensure timely addressing of referrals
• Train relevant stakeholders (MDs and CNs) on the external referral process
• Assist with prior authorizations as needed
• Serve as single point of contact between specialists, clinic physicians, and patients for care outside the clinics; provide updates to clinical teams
• Use clinical judgment to identify appropriate provider types and prioritize referral urgency, consulting clinical team members as needed
• Prepare and submit complete referral packets with necessary clinical documents to specialists
• Confirm packet arrival and timely scheduling of patient appointments
• Navigate patient insurance benefits and consult benefit specialists for high-quality, cost-effective care
• Troubleshoot complications or unexpected issues to prevent gaps in care
• Regularly interface professionally with primary care MDs, RNs, and clinic hosts
• Assist in developing technology and service improvements for communication and coordination with providers and specialists

Requirements

• Minimum of 3 years applicable experience
• High school diploma or GED
• Proficient with Google spreadsheets, Excel, database management, and data tracking

Qualifications

• High school diploma or GED required
• Minimum of 3 years applicable experience; primary care experience preferred

Nice to Have

• Bachelor’s degree or relevant medical experience
• Experience processing referrals in a medical group
• Creative, flexible, able to manage obstacles effectively
• Strong task execution and follow-through skills
• Comfort with ambiguity in problem-solving
• Ability to thrive in a fast-paced, rapidly changing environment
• Skilled at using multiple technology platforms simultaneously with clinical judgment
• Organized and accountable in dynamic environments
• Strong communication, customer service, and interpersonal skills
• Excellent problem-solving and proactive problem-prevention abilities
• Willingness to provide exceptional assistance
• Team-oriented with ability to improve workflows and referral management systems

Skills

* Required skills

Benefits