Lead, Patient Care Navigator

At Rely Health, each patient receives a steadfast companion on their healthcare journey. Empowered with technology, our patient care navigators not only ensure high-quality engagements, but also make comprehensive care more cost-effective and accessible for all patients.

The Lead is knowledgable in patient care navigation and will manage escalated calls from patients and family members and ensure top customer service is being met by the team.  The Lead coordinates and conducts training for the PCNs, manages schedule and schedule changes, recruits and onboards new PCNs and oversees day to day performance of the patient care navigators.   Understands each navigator's daily workflow as it pertains to clients, Rely Health technology platform to ensure the workflows and processes to ensure metrics for the client is met.  Monitors Rely Health technology suite to ensure navigator and client metrics are being met. 

Care Navigation

• Manages escalated calls from team when a patient or family member has a concern

• Provide escalated coordination across multiple patient care pathways using tech-enabled workflows

• Establishes digital workflows to optimizing workflows to enhance efficiency in care coordination

• Clearly communicates the purposes and services available to patients, family members, and caregivers.

• Maintains frequent contact with client or hospital/clinic leadership to assist with other duties as assigned for participation in client or hospital/clinic initiatives. 

• Aids in customer service, patient experience by maintaining a non-judgmental, calming presence and relaying feedback or patient issues to appropriate clinical or patient experience staff.

• Investigate and resolve patient/provider inquiries and concerns in a timely manner.

• Maintains documentation of all client encounters in appropriate software applications or tools; completes reporting requirements according to program standards. 

• Enter detailed information into company proprietary software while conversing with patients.

• Analyze patient data to identify care gaps and initiate outreach based on performance metrics. 

• Collaborate with AI tools to streamline patient interactions, focusing on higher acuity cases.  

• Meets key performance indicators including service levels, call volumes, adherence and quality standards.

• Leads team meetings regularly with active engagement and collaboration.

• Serves as backup to the call queue and scheduling teams as needed.

Program Lead

• Oversees completion of assigned day-to-day operations of the team.
• Drives performance and improvements within their immediate navigation team, effectively creating urgency and accountability of team members to achieve program goals and client success

• Leverages performance and program data insights to initiate and implement program improvement measures, under the direction of the Supervisor and Rely Health leadership.

• Aids in daily, monthly, and quarterly operations reporting.

• Shadows and observes team member workflows and utilization of technology, offering enhancement suggestions as necessary.

• Assists with evaluation of team members in coordination with Supervisor, Program Operations.

• Travel  as needed to practice locations for implementation, personnel or project support.

• Supports ad-hoc and temporary tasks, projects, programs, and individual assignments as requested.

• Aids in recruitment, hiring, and training of team members.

• Manages shift schedules and individual team member shifts as needed to ensure all shifts are covered to meet client needs.

• Assists with real time service recovery needs to clients to understand issues/concerns and implement coaching and/or process improvement plans to address the issues/concerns.

• Collaborates with immediate manager to identify workflow changes.
  
  Program Enrichment & Training                                                                                                                                                                                                     

• Contributes to problem solving with the team through communication, collaboration, data collection, critical thinking, evaluation of options and solutions to further the patient progress toward care plan goals.

• Takes initiative to develop knowledge, skills and abilities to perform at a high level, including staying abreast of related care management news, documentation, literature and continuing education.

• Supports quality initiatives collaboratively developed with payor partners through care gap closure campaign outreaches designed to engage patients and caregivers, increase treatment adherence and better health outcomes for covered populations.

• Is willing to test and utilize new tools or product features. 

• Trains new team members on the role, including evaluations and providing feedback as necessary. (Some travel may be required)

• Trains other team members on new technology and platform capabilities and elicits feedback to provide to appropriate team members for product enhancements.

• Create training content for team members on the use of technology tools and workflows.

• Coordinates training for new team members

• Point of contact for site needs and developments of new initiatives or workflows to contribute to client or hospital/clinic goals and initiatives.

• Reports to Rely Health leadership on program enhancement ideas, group workshops, statuses of projects, and participates in quality initiatives. 

Technology Integration 

• Regularly engage with and integrate new technology solutions into the workflow of patient care navigation process to enhance job efficiency.

• Remain adaptable and responsive to the continuous evolution of healthcare technology solutions, including software updates, new tools and digital communication platforms

• Utilize technology platforms to enhance efficiency of the Lead role

• Monitors metrics in Rely Health tools and reports out to team and clients as needed

• Works in collaboration with the product team to provide feedback and trial new enhancements before they are rolled out to the full team.  Provide feedback on the efficiency and user experience of new product features. 

Requirements

Minimum Required Qualifications:

• High school diploma or GED

• Knowledge of health insurance, billing practices and intricacies of healthcare systems
• Ability to maintain a high level of productivity autonomously
• 2+ years of patient care navigation experience 
• Familiarity with healthcare technology platforms and tools
• Understanding of and ability to comply with all HIPAA and confidentiality requirements
• Ability to work independently and lead a team in a fast-paced, demanding environment with minimal supervision. 
• Ability to manage and oversee multiple tasks simultaneously, including high daily call volume
• Ability to communicate effectively, both orally and in writing
• Ability to create effective rapport with a diverse group of patients and care providers
• 1+ years of experience leading people

Preferred Qualifications:

• Experience working with individuals within hospitals or public health settings.
• Experience with underserved populations.
• Knowledge of Medicare, Medicaid and commercially insured payer common practices and policies
• 40+ wpm typing proficiency
• Experience documenting in electronic health record system or similar
• Experience using technology, apps, software

Competencies (Knowledge/Skills/Abilities):

• Knowledge of medical terminology.
• Knowledge of Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) rules and practices.
• Knowledge of computer skills using Microsoft Word, Excel, and Outlook, as well as video conferencing and using the Internet.
• Ability to learn new technology solutions and be ok with constant change in technology
• Demonstrated strong customer service orientation skills and telephone etiquette.
• Ability to communicate effectively in both verbal and written forms.
• Ability to remain organized and manage competing priorities.
• Ability to work within established timeframes as part of a care team or independently.
• Ability to develop relationships with patients and care team members.
• Ability to respectfully listen to patient and care team without interruption to understand patient needs, expectations, values, and perspectives; ask appropriate questions to ensure understanding; and respond appropriately.
• Ability to use logic and reasoning to approach problems and identify alternative solutions.
• Flexible and creative problem solver.
• Non-judgmental and energetic.

Rely Health does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Rely Health is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

Benefits

• Medical, Dental Vision
• Life Insurance
• Short and Long Term Disability
• 11 Paid Holidays
• Vacation Time
• Sick Time
• 401(k)
• Technology reimbursement
• Professional development

Target Start Date: November 1, 2024

Location: Olympia Fields, IL

FLSA Status: Non-Exempt

Job Status: Full Time

Work Schedule: Monday - Friday with occasional evenings and/or weekends

Vehicle Required: No

Amount of Travel Required: 5% - Local Area Travel

Reports To: Supervisor, Program Operations

Salary Range: $25-$28/hr DOE

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