Patient Care Navigator at Park DuValle Community Health

Description

Park DuValle Community Health Centers (PDCHC) is seeking an experienced Patient Care Navigator to help support members through education, coordination, and follow-up to ensure access to physical and mental health services, preventive care, and necessary resources. This role acts as a liaison between the health plan, providers, and members to close gaps in care and improve overall health outcomes.

Essential Duties & Responsibilities Include:

Member Education & Engagement

• Educate members about physical and mental health, preventive care, and the importance of scheduled health assessments, screenings, and vaccinations. 

• Conduct outbound calls to educate members and schedule appointments, including comprehensive health assessments within ninety (90) days of identification through health plan quality reports. 

• Remind members of upcoming appointments and answer questions related to their care.

Care Coordination & Follow up

• Take inbound calls from members to answer questions about scheduled or missed appointments.

• Conduct outbound calls following provider appointments when necessary.

 • Complete follow-up calls after a member’s discharge from inpatient or emergency care to ensure appropriate follow-up appointments are scheduled within seven (7) to thirty (30) days.

 • Refer members to the health plan for benefit-related questions, including covered services and transportation needs.

Collaboration & Compliance

• Work with the health plan to submit applicable medical records and ensure care delivery meets quality standards.

 • Report suspected member fraud to the health plan. • Participate in ad hoc teleconferences and respond to health plan requests within two (2) business days or sooner, as required by law.

Requirements

 • High school diploma or equivalent; associate or bachelor’s degree in health-related field preferred.

 • Experience in care coordination, patient navigation, or a healthcare-related role.

 • Strong knowledge of preventive care, health screenings, and care management processes. 

• Excellent verbal and written communication skills. 

• Ability to work independently and as part of a team.

• Proficient with electronic health record systems, scheduling software, and Microsoft Office Suite.