[Hiring] Patient Navigator @University of Miami

Role Description

The Patient Navigator facilitates patients’ ability to obtain services by identifying barriers to care, coordinating the development of treatment plans, and monitoring the implementation and follow-up of services ordered by caregivers.

Core Responsibilities

• Conducts patient evaluations to obtain information necessary for the development of an effective treatment plan.
• Ensures patients have access to insurance and social service programs for which they are eligible.
• Provides patient reminders of upcoming appointments and acts as liaison between patients and providers.
• Identifies and resolves real or perceived barriers to care.
• Educates and counsels patients on issues related to their health and life situations.
• Maintains current knowledge of community health, welfare resources, and any other programs available to patients.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
• Maintains a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
• Maintains knowledge of insurance referral requirements to ensure access based on third party reimbursement criteria.
• Ensures that the appropriate appointment and registration information is documented at time of scheduling.
• Adheres to policies and procedures regarding appointment scheduling and registration processes, performing these tasks accurately with attention to detail to ensure the highest quality standards.
• Adheres to standards provided by the HIPPA Privacy Office related to patient privacy and confidentiality.
• Initiates pre-registration process and coordinates with the Central Insurance Verification and Patient Access teams to assure pre-registration in the appropriate facility prior to the appointment.
• Provides verification of enrollment and deductible status for persons enrolled in the School's special contract programs.
• Notifies appropriate parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements.
• Contacts insurance company through telephone; inquires about patient information and benefits.
• Inquires via insurance companies and HMO’s about referral, authorization information and letters.
• Intervenes as liaison/advocate for patients, physicians, and staff in facilitating ease of care.
• Assists in identifying trouble spots and problem patterns in the provision of care.
• Intercedes for the patient as needed to obtain prompt, efficient, effective care (e.g. medical explanations, reduced waiting, billing inquiries, cost estimates).

Qualifications

• High School diploma or equivalent required.
• Minimum 3 years of relevant work experience required.
• Ability to process and handle confidential information with discretion.
• Ability to communicate effectively in both oral and written form.
• Ability to handle difficult and stressful situations with professional composure.
• Ability to maintain effective interpersonal relationships.
• Ability to understand and follow instructions.
• Building partnership with local community physicians and referral sources to the UHealth Systems.
• Maintaining communication with patients and the healthcare providers to monitor patient satisfaction with the patient care experience.
• Arranging any special needs such as transportation, interpreting services, etc. as needed for the patient’s appointment.
• Facilitating financial support, assistance with paperwork or medical records and linkage to follow-up services.
• Preparing routine departmental correspondence to referring agencies and primary care providers.
• Serving as a liaison between the patients, the UHealth Systems, Medical Providers in order to increase the utilization of appropriate primary care and tertiary services.
• Maximizing patient use of appropriate and established health services, assisting and guiding patients in receiving medical services, educating patients on the appropriate utilization of care, appointments and treatments services, ensuring that patients are able to access and keep medical appointments.
• Appointment setting and referral management as defined.
• Any relevant education, certifications and/or work experience may be considered.

Benefits

• Competitive salaries.
• Comprehensive benefits package including medical, dental, tuition remission and more.

Company Description

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the groundbreaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.