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Summary:
Supports the Care Management department in caring for rising risk and high-risk patients and plays a key role in obtaining information about patients with medical and social needs. The Care Navigator acts as a resource to assist patients in navigating the healthcare system and works closely with the care team(s) to identify patients* needs as well as community resources that will enable the patient to obtain optimal health outcomes transition safely and reduce unnecessary hospital utilization.
Responsibilities:
Screens patient census using provided criteria to determine if the patient should be categorized as high risk Manages the high-risk patient census to assess if intervention from the Nurse Care Manager (NCM) or other disease management/population health program is needed Assesses patients for basic needs and intervenes when appropriate referring patients with greater needs to the NCM for intervention Works closely with the NCM to help patients reach their goals maintain safety and improve their health Has awareness and understanding of community and Coastal resources/teams to offer patients Hands off communication to the NCM or other Coastal program when necessary Works with the NCM to develop and update patient care plans and attends care conferences and huddles as needed Performs telephonic and remote patient outreach to patients documenting all outreach and interventions in the electronic medical record (EMR) Facilitates and reinforces patient self-management under the direction of the NCM and encourages patients to keep up to date with labs PCP and specialist visits and their care plan Evaluates for patient safety Ensures documentation is collected from patient specialist visits Provides resources and disease management education to patients Comfortable with MOLST and durable power of attorney forms to lightly discuss with patients Understands durable medical equipment (DME) needs and referrals Has in-depth understanding of medical insurances and benefits Assists patients with transportation needs Performs other job-related duties as assigned
Other information:
Education and Experience
High School Diploma or equivalent
Medical Assistant Certification or equivalent clinical training
At least 1 year of experience directly related to the duties and responsibilities of the position
Knowledge Skills and Abilities
Ability to work both on a team and independently with the ability to self-direct
Capability to multi-task and operate under pressure with the capacity to think critically and problem solve
Strong interpersonal and communication skills (both verbal and written) with the ability to effectively communicate with patients providers and office personnel
Must have excellent phone etiquette and be committed to providing superior service to all
Ability to show care and compassion when dealing with patients
Must be flexible and receptive to change with the ability to learn quickly and retain new information
Ability to maintain quality safety and /or infection control standards
Working knowledge of medical terminology
Excellent organizational skills with superb attention to detail
Skilled in the use of technology and a variety of software programs including Microsoft Office
Physical Effort and Dexterity
Sit and stand for prolonged periods of time
Work and move among all departments of Coastal Medical
Excellent hand/eye coordination
Lift up to 15 pounds
Manual dexterity to operate a personal computer or laptop as well as standard office machines and equipment as it pertains to one*s position
Visual Acuity Hearing and Speaking
Capability to transfer information from original source to paper computer telephone and in person
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.
Location: CM-Narragansett -Narragansett Family Medicine -360 Kingstown USA:RI:Narragansett
Work Type: Full Time
Shift: Shift 1
Union: Non-Union
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual identity or orientation, ancestry, genetics, gender identity or expression, disability, protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.