14 days old

RN Office Navigator - Harvey, LA

New Orleans, LA 70112
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  • Job Code
    869319

What you do matters. And who you do it for matters even more. If you're looking for more meaningful impact, you should take a serious look at our growing organization. Since our founding in the mid-90's, Peoples Health has brought innovation and compassion to Medicare patients throughout Louisiana.  Now, part of the UnitedHealth Group family of companies, our team consists of over 900 people who are experienced in all aspects of care delivery, health maintenance and administrative support. It's our goal to help guide over 60,000 Medicare recipients across the broad spectrum of health and dental services. We're committed to the highest purpose; improving lives. And that makes us the singular place to do your life's best work.(sm)

 

The Office Navigator, as a part of the primary care patient centered medical home team, engages in a collaborative process, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a member's health needs through communication and available resources to promote quality, cost effective outcomes. The Office Navigator is responsible for ensuring a member's encounter with providers, office staff, and Peoples Health is seamless and comprehensive. The Office Navigator will review, plan, and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve member's health outcomes.

 

This position that will be located in a clinic located in Jefferson Parish, West Bank side in  Harvey, Louisiana

 

Primary Responsibilities:

  • Identifies and communicates community and Peoples Health departmental concerns to the appropriate department
  • Understands Peoples Health plans, assists members with appropriate utilization of their benefits and provides answers to plan related questions
  • Assists member with scheduling appointments with the primary care provider (PCP), specialists', referrals, follow-up testing and/or office procedures
  • Assists members to make optimal use of their primary care provider's office encounters
  • Coordinates services requiring authorizations and ensures appropriate documents are submitted
  • Prior to scheduled appointment with the primary care provider, conducts pre-visit planning by reviewing data in People Health systems and the PCP's electronic medical record (EMR)
  • Creates a -fact pack- for the provider by identifying HEDIS/Star measures needed, reviews current and past medication record, and current services being provided
  • Utilizes and documents appropriate referrals to coordinate needed resources for member; i.e. pharmacy, durable medical equipment (DME), social services, home health, chronic care improvement, etc.
  • Submits appropriate documentation to support referral
  • Ensures receipt, review and documentation of test and treatment results
  • Maintains accurate documentation in the member's medical record
  • Communicates post-hospital discharge visits and documents services and protocols appropriately needed and requested
  • Within seven (7) days following post-hospital discharge, coordinates with other team members, to perform medication reconciliation and alert provider to any issues and/or discrepancies
  • Receives, reviews, and shares with primary care provider's office manager, the monthly HEDIS/Star measures report in order to coordinate an action plan for improved measure performance and outcomes for the members
  • Provides a business card for future coordination and communication with providers
  • Assists with other duties as assigned


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Posted: 2020-03-21 Expires: 2020-04-21

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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RN Office Navigator - Harvey, LA

UnitedHealth Group
New Orleans, LA 70112

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