About the position
The position serves as a crucial link between patients and their healthcare providers, ensuring that patients receive the necessary care and support throughout their healthcare journey. The role involves conducting outreach calls to patients who are due for preventive services, identifying and addressing barriers that may prevent patients from accessing care, such as transportation, insurance, and language issues. This position also requires assisting patients in arriving at their appointments on time and prepared, which may include arranging transportation when necessary. In addition to direct patient interaction, the role includes scheduling follow-up appointments, consultations, and support services in accordance with established service standards. The individual will create concise patient summaries for the care team and document recommendations using standardized care protocols that align with healthcare guidelines. Developing patient education programs and tools on critical health topics such as Hypertension, Breast Cancer Screenings, and Diabetes is also a key responsibility, along with working on projects aimed at improving healthcare outcomes. Monitoring patients throughout the care continuum, including during inpatient admissions, is essential, as is collaboration with inpatient care management resources. The position requires preparing and delivering regular reports on outcomes and performance improvement activities, adhering to established productivity standards, and attending training sessions for professional development. Maintaining positive working relationships with various departments, including physicians, office staff, diagnostic staff, nurses, and community organizers, is vital for success in this role. The individual will also manage detailed Quality Improvement (QI) Dashboards, collect and document patient feedback in the Electronic Medical Record (EMR) system, and provide program updates as needed. Willingness to travel between clinic sites may be required, and the individual will perform other duties as assigned.
Responsibilities
- Act as a vital connection between patients and their care providers.
- Contribute to performance improvement initiatives.
- Conduct outreach calls to patients due for preventive services.
- Identify and address patient barriers such as transportation, insurance, and language issues, and refer them to additional resources as needed.
- Assist patients in arriving at their appointments on time and prepared, including arranging transportation if necessary.
- Schedule follow-up appointments, consultations, and support services within the defined service standards, such as with dietitians, physicians, and specialty departments.
- Create concise patient summaries for the care team and document recommendations using standardized care protocols in line with guidelines.
- Develop patient education programs and tools on topics like Hypertension, Breast Cancer Screenings, and Diabetes, and work on projects aimed at improving healthcare outcomes.
- Monitor patients throughout the care continuum, including during inpatient admissions, and collaborate with inpatient care management resources.
- Prepare and deliver weekly, monthly, and quarterly reports on outcomes and performance improvement activities.
- Adhere to established productivity standards.
- Attend training sessions and professional development opportunities to enhance knowledge and practices.
- Maintain positive working relationships with key departments, including physicians, office staff, diagnostic staff, nurses, and community organizers.
- Manage detailed QI Dashboards.
- Collect and document patient feedback and information in the EMR system.
- Provide detailed program updates or anecdotes as needed.
- Be willing to travel between clinic sites if required.
- Perform other duties as assigned.
Requirements
- High school diploma or GED required (Associate's degree preferred).
- Certification as a Medical Assistant preferred.
- Familiarity with HEDIS measures and UDS is important.
- 1-2 years of experience with FQHCs or community health centers.
- Completion of a Patient Navigator Training Collaborative or equivalent education and experience is advantageous.
- Experience with EPIC or similar electronic health record systems is preferred.
- Strong problem-solving, decision-making, and critical thinking skills required.
- Typing speed of 35 WPM.
- Excellent leadership, organizational, written, verbal communication, and interpersonal skills.
- Ability to work independently and lead teams effectively.
- Strong presentation skills.
- Adaptability to change and innovation.
- Ability to collaborate with team members.
- Capability to implement both professional and community-based education programs.
- Proficiency in Microsoft Office is required.
- Must provide proof of up-to-date COVID-19 vaccinations, including all recommended doses and booster shots when eligible.
