The Care Navigator is responsible for coordinating access to ARH services across all areas of their healthcare community (includes hospital, retail pharmacy, home care, home health, indigent care, etc.).
• Work collaboratively with care providers to coordinate and plan access to care for patients across the ARH continuum.
• Work with nursing and care managers to identify ARH service opportunities, including retail pharmacy, home care services, home health services, and other resources for patients being discharged.
• Make follow-up contacts to high-volume patients for local and system services.
• Provide a local resource to transition follow-up services, such as prescription refills, through system services including prescription mail-order programs.
• Promote and coordinate home care services for post-discharge durable medical equipment and home health orders.
• Deliver completed prescriptions and supplies to patients or their caregivers.
• Assist patients in processing payment requirements.
• Assist in the completion of paperwork for medication access programs.
• Contact other resources for patient information to enhance ARH services.
• Work with physicians and social services to obtain insurance prior authorizations for medications as needed.
• Coordinate with local service line directors to provide continuous and coordinated services following discharge.
• Serve as a liaison between providers and pharmacy personnel to facilitate the prior authorization process and resolve medication access and adherence issues.
• Act as a direct contact for patients requiring assistance or updates regarding prior authorizations.
• Initiate follow-up communications with patients and providers concerning the status of medication access issues.
• Perform direct entry and maintenance of patient applications for services.
• Respond to and provide additional information and/or appeals as required by pharmaceutical companies.
• Maintain records and statistics for evaluation and program analysis purposes.
• Maintain general knowledge of manufacturer indigent patient program criteria and communicate changes and developments.
• Investigate and analyze critical operational situations and provide direction for problem resolution.
• Perform other related duties as assigned.
• Travel as required.
• High School Diploma required.
• Associate's Degree preferred.
• Experience requirements not specified.
• Licensed Practical Nurse (LPN) State Licensure preferred upon hire.
• Ability to work collaboratively with care providers to coordinate patient access across the continuum of care.
• Ability to assist patients with medication access, financial assistance programs, and prescription services.
• Knowledge of healthcare services, discharge planning, and community resources.
• Ability to communicate effectively with patients, caregivers, physicians, pharmacies, social services, and insurance providers.
• Ability to obtain, track, and follow up on medication prior authorizations.
• Ability to maintain accurate records, statistics, and patient program documentation.
• Ability to investigate and resolve medication access and operational issues.
• Strong organizational, communication, and customer service skills.
• Ability to handle sensitive patient information confidentially.
• Ability to travel as required.
Software Powered by ICIMS
www.icims.com