Patient Navigator

**Are you looking for a career opportunity that gives back to your community?Look no further than Beloit Area Community Health Center located in Beloit, WI, a part of Community Health Systems, Inc. (CHS)!** **JOB SUMMARY:** The Patient Navigator helps patients get the health care and other resources they need to be as healthy as possible. Patient navigators work with people, their families, and their caregivers to overcome barriers to healthcare screening and diagnosis, healthcare services, and the resources needed to ensure access to healthcare services in the areas of medical, dental, and behavioral health. This position within CHS will focus on ensuring that the patients who receive services are provided comprehensive, integrated care. A dynamic, self-motivated individual is required to help ensure that bridges to care are built between different disciplines and that our patients who need comprehensive care follow through with it. Individuals with a strong presence, a good working knowledge of medical, dental and behavioral healthcare terminologies and who are engaging / interactive are strongly encouraged to apply for this role. **ESSENTIAL JOB FUNCTIONS:** The Patient Navigator works in collaboration and continuous partnership with patients needing specialized support and their family/caregiver(s), clinic/hospital/specialty providers and staff, and community resources in a team approach to: - Promote timely access to appropriate care - Increase utilization of preventative care - Reduce emergency room utilization and hospital readmissions - Increase comprehension through culturally and linguistically appropriate education - Screen for Reduce barriers to treatment determined during SDoH screening - Create and promote adherence to a care plan, developed in coordination with the patient, care team, and family/caregiver(s) - Monitor waitlist and resource lists and ensure all schedules are at maximum capacity - Manage internal and external referrals and assist patient in removing any barriers to completing the referral - Increase continuity of care by managing relationships with tertiary care providers transitions-in-care, and referrals - Increase patients’ ability for self-management and shared decision-making - Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction and reducing health care costs. - Key performance indicators - Conduct a minimum of 1,200 in-office/virtual visits per year - Work with patients to plan and monitor care: - Assess patient’s unmet health and social needs - Develop a care plan with the patient, family/caregiver(s) and providers (emergency plan, health management plan, summary, and ongoing action plan, as appropriate) - Monitor adherence to care plans, evaluate effectiveness, monitor patient progress in a timely manner, and facilitate changes as needed - Create ongoing processes for patient and family/caregiver(s) to determine and request the level of care coordination support they desire at any given point in time - Facilitate patient access to appropriate specialty providers - Educate patient and family/caregiver(s) about relevant community resources - Facilitate and attend meetings between patient, family/caregiver(s), care team, payers and community resources, as needed - Cultivate and support primary care and specialty provider co-management with timely communication, inquiry, follow-up, and integration of information into the care plan regarding transitions-in-care and referrals - Assist with identification of “high risk” patients (the chronically ill and those with special health care needs), and add these to the patient registry (or flag in EHR) as appropriate. - Attend all Patient Navigator training webinars and meetings - Follows all CHS policies, procedures, regulatory and legal requirements **PREFERRED QUALIFICATIONS:** **Skills/Abilities** - Ability and determination to efficiently carry out Community He…