Patient Navigator

Job Summary:

The Patient Navigator utilizes a high level of knowledge of the disease process in the coordination of critical medical information for the specialty department. The coordinator will work directly with physicians, nurse practitioners, and nursing staff and will effectively communicate medical issues with physicians and nurses. The coordinator will coordinate care with referring providers inside and outside of the Kaiser Permanente which includes hospital systems, radiology, imaging studies, surgical procedures, and external physicians. In conjunction with the specific specialty guidelines, the coordinator will review data received prior to visit and utilize judgment in the appropriate and timely scheduling of appointments that are in line with the treatment. The coordinator will demonstrate the ability to be self-directed and act independently to manage multiple scheduling tasks at once and intervene as appropriate to resolve issues.

Essential Responsibilities:

• Understand and utilize direct template management in the daily coordination of member appointments. Ensures that members are scheduled with the appropriate subspecialist within a department.
• Asks pertinent questions to ascertain need for office visit and assist in scheduling appointments if necessary based on guidelines established by the department providers.
• Facilitate member appointments as triaged by the specialty providers, as well as lab, radiology, consultants and for follow-up encounters as ordered by MD or AP.
• Assist with the day to day management of new patient referrals from internal and external providers, as well as self-referrals.
• Act as a resource for the call center and advice for appropriate scheduling of members within a department.
• Responsible for new patient consult research of external medical records, procedures, pathology and radiology reports and lab test results.
• Maintains and updates medical record files, specialty charts and completes disability forms.
• Responsible for communicating with external referring providers, patients and family members in order to determine the specific types of medical records needed and where to obtain them and documentation of the date requested, name of person contacted and date received to include imaging films and reports, CT Scans, pathology reports, operative notes, office visit notes, lab data, from external systems along with internal imaging films and new patient consult notes.
• Responsible for making the above information available for the provider interview during a new consult visit.
• Provide a direct and immediate available resource for internal and external providers who may have STAT or urgent referrals.
• Asks pertinent questions to ascertain need for office visit and assist in scheduling appointments if necessary based on guidelines established by the department providers.
• Responsible for maintaining accurate record keeping, referral database and generating reports on referral activity.
• Consults with Practitioners, RNs, and Nursing Supervisor to provide information relating to the department. May arrange hospital admissions under the supervision of a RN.
• Answers inquiries from external/internal providers, HCT members, patients and family members by telephone or in person relating to the information needed in the referral process.
• Participates in departmental QA activities; assists supervisor in compliance with regulatory agencies, development and revision of general procedures and standards.
• Maintains statistical data as requested by provider or supervisor.
• Responsible for coordination of communication of the need for the patient to have other laboratory and radiology tests to patients, family members, and referring provider. Also responsible for receipt of results and reviewed results with the timing of the consult visit.
• Assist with the maintenance and revision of clinic templates.
• Maintains CPR certification.
• Assists in orientation of staff as needed.
• May perform other duties as assigned.

Basic Qualifications:

Experience

• Minimum five (5) years of medical office management or research field experience, customer service experience or related field.

Education

• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• N/A

Additional Requirements:

• Complete a Customer Service Assessment.
• Customer service aptitude demonstrating through Customer Service Assessment.

Preferred Qualifications:

• Prior Clinic Managerial Experience.