Title: Patient Flow Navigator

Location: MemorialCare – Orange Coast Medical Center

Department: Breast Center

Status: Full Time

Shift: Days (8hr)

Pay Range*: $27.00/hr - $40.00/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

The Patient Care Navigator works under the direction of the Breast Center manager. The position is responsible for working closely with the technologists, nurse navigator and radiologist to navigate patients through the process of coordinating needed diagnostic breast exams, ancillary care, and physician/surgeon appointments; including but not limited to obtaining pertinent insurance information and authorization, explaining details of next steps, obtaining medical records/releases, managing the high-risk program and the BiRad 0,4,5,6 process.

Essential Functions and Responsibilities of the Job

·Assists the Nurse Navigator and technologists with tasks related to navigating patients through the process of obtaining needed breast or surgical care.

·Manages the BiRad 0,4,5,6 results ensuring patients with positive findings receive the appropriate care and needed next steps for an accurate diagnosis. Collaborates with radiologist to review patient medical records to analyze and minimize clinical risk and conduct risk assessments using clinical recommendations based on the American College of Radiology (ACR) practice guidelines, National Comprehensive Cancer Network (NCCN) guidelines and other recognized approved practice guidelines to support program achievements.

·Operates the high-risk program for follow-up screening and diagnostic exams.

·Maintains a positive professional relationship with OCMC Breast Center team, physicians, surgeons, and ancillary providers.

·Collaborates with the Admitting team to support the financial aspects of Breast Center services such as, verification of insurer benefits, authorizations, cash pricing options, and reimbursement of services provided.

·Works with the entire Breast Center team toward achieving all quality care and data goals.

·Ability to be at work and be on time.

·Ability to follow company policies, procedures and directives.

·Ability to prioritize and multitask.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

·        5 years of experience in the breast healthcare industry, preferred

·        Knowledge of commercial, government, and managed care authorization process, preferred

·        Proficient in computer systems, software applications, and data entry, preferred

Education/Licensure/Certification:

·        Associate’s degree, preferred

·        Medical Assistant Certification, preferred

·        Navigator Certification, preferred