Company :

Allegheny Health Network

Job Description :

GENERAL OVERVIEW:

Serves as a communication facilitator for patients, referring physicians, and caregivers. Identifies new and recurring patients, provides welcoming and comfort calls and assists the Nurse Navigator with patient flow. Works with the Nurse Navigator to facilitate a plan which provides clinical and support care to the patient, including scheduling of appointments and utilization of supportive care services within the Network. Takes lead and assumes responsibility and accountability for the management of resources through the interdisciplinary collaboration to achieve optimal patient outcomes.

ESSENTIAL RESPONSIBILITIES:

• Responsible for community outreach and high risk populations to connect the patient to appropriate clinical care. Coordinates data, community services and AHN resources into a seamless model of access and care benefiting patients, physicians and family members.

• Provides the patients with a welcoming/courtesy call, and post visit comfort call and is available for any questions or concerns the patient/family may have. Provides patient with welcoming/hospitality packet to include information related to supportive services and programs that are available. Leads process improvement strategies within the patient's experience to improve flow and operations.

• Assists patients in scheduling appointments as needed including all aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc.), and facilitates the patient journey to procedures and visits as needed. Coordinates with Nurse Navigator and other members of the health care team to facilitate all aspects of the patients care. Works with CM/RN/SW to facilitate the patient's transfer of care. Integrates and facilitates care for patients across care continuum.

• Trends data and outcomes required for the navigation program. Provides surveys for patients and completes log of data and desired outcomes. Tracks patient concerns and complaints and provides service recovery to the patients in addition to notifying the clinical staff of those issues. May work with and assist cancer registry staff to obtain data to evaluate patient outcome information related to the care delivery model.

• Identifies the patient's insurance concerns and issues and facilitates resolution.

• Works as a liaison between the hospital and post-acute providers.

• Provides support to the patient's family members and caregivers. Identifies problems and opportunities and takes appropriate action.

• Leads team of navigators, liaisons and volunteers to improve the patient experience. Performs other duties as assigned or required.

QUALIFICATIONS:

Minimum

• Associate degree or equivalent experience

• 3 years of clinical experience in physician office practice or hospital

• Competency in Excel, Word, and Power Point

Preferred

• Knowledge of the healthcare delivery system, resources, community for the oncology population

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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Req ID: J236413