Position Summary:
Triad Adult and Pediatric Medicine Inc. (TAPM) Outreach and Enrollment Navigator will guide patients through the health care system and help them overcome barriers that prevent access to affordable quality healthcare. This position will assist patients with obtaining potential healthcare coverage through the following means: TAPM sliding fee, GCCN Orange Card sliding fee, Medicaid, ACA (Affordable Care Act) open enrollment, Med Assist, etc. This position will connect new and established patients with other community resources to help overcome barriers to care and assist with decreasing medical debt and social drivers of health for vulnerable populations.
The Outreach and Enrollment Navigator will assist individuals and communities in adopting healthy behaviors by providing ongoing education, outreach, and social support. Works in conjunction with outreach staff, patient navigator(s) and eligibility and enrollment teams. Responsible for tracking and documenting as appropriate for data collection and improved patient outcomes.
Primary Job Responsibilities:
Assists eligible patients with TAPM sliding fee applications, GCCN Orange Card sliding fee applications, Medicaid applications, E-Pass, ACA (Affordable Care Act) open enrollment, Med Assist, etc..
Ensures all insurance, demographic, eligibility, and clinical information are obtained and entered in the EHR system accurately.
Assists with determining sliding scale fee eligibility.
Assists and Schedules the initial new patient appointments for newly enrolled patients as needed.
Educates patients regarding insurance plan options, coverage details, benefits, enrollment processes, resources, and available TAPM services.
Identifies and connects patients to resources to overcome barriers to care such as the social determents of health SDOH (i.e., financial assistance, medication assistance, transportation, and housing, etc.).
Notary Public – perform duties as a notary to assist patients and staff with eligibility and enrollment and other legal documents.
Documents and tracks all interactions with patients/others appropriately to ensure proper documentation and data collection as needed for program reporting and tracking.
Participates in community outreach events to educate patients on available services for uninsured/underinsured as well as possible insurances available through Medicaid expansion to eliminate and/or decrease medical debt.
Attend community meetings or health fairs to understand community issues or build relationships with community members.
Partner with care team (community, providers, and internal staff)
Ability to travel locally as needed.
Ability to lift, bend, and/or stoop.
Lift 25 pounds without assistance.
Ability to drive and operate an outreach vehicle/van.
Knowledge and learning of continued cultures and values.
Participate in professional development, staff meetings, continuing education, quality improvement initiatives to improve efficiency and effectiveness of patient health outcomes.
Abides by Health Center guidelines, policies and procedures, and HIPAA regulations.
Willingly perform other duties as assigned.
Minimum Qualifications
1 to 3 years of experience in healthcare, customer service, education, community outreach, public health, benefits enrollment, and/or related fields.
Bilingual Preferred (English/Spanish)
Preparation and training:
• Proficiency in Microsoft Office Outlook, Word, Excel, PowerPoint use and e‐mail communication.
• Excellent verbal and written communication skills.
• Must be able to work with changing priorities.
• Requires excellent organizational, problem solving and critical thinking skills.
• Must be able to interact with individuals of all cultures and levels of authority.
• Requires the ability to maintain confidentiality.
• Must be able to function as part of a team and work independently without direct supervision.
• Experience with electronic documentation systems.
Analytical Ability:
Repetitive, routine, or semi-routine duties involving the use of numerous established clerical, statistical, and/or other general procedures. Involves average detail and variation, and where the employee is responsible for recognition of previously described sets of circumstances and correct choice of action within limits of clearly prescribed standard practices and procedures, requiring the making of contingency decision and the use of some judgment.
Independent Judgment:
Under general supervision, whereby standard practice enables the employee to proceed alone on regular duties, referring questionable cases to supervisor or others.
Safety of Others:
Safety of others depends entirely on the correct action of employee on job being rated. Failure to perform job duties as trained could result in patient harm or the reputation of the organization.
Working Conditions:
The work environment characteristics described here are representative of those an employee. encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Moderate noise (i.e., business office with computers, phone, and printers, light traffic)
• Ability to work in a confined area.
• Ability to sit at a computer terminal for an extended period or drive long distances.
• Active and current NC Driver’s License and auto insurance.
Mental Attention or Visual Demand:
Continuous mental and visual attention and manual dexterity when attending to patient care and medical record keeping; usually repetitive work or diversified operations requiring constant alertness or activity. Must have acute visual perception for patient care and record keeping requirements and be able to distinguish colors. Must be able to communicate via telephone and other automation vehicles. Normal or corrected vision is needed to visualize computer screens, medical record forms, and equipment screens. Normal or corrected hearing is required for hearing overhead pages, building alarms, etc.
Physical Demand:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to, stand, sit, talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach, stoop & kneel to install computer or AV equipment.
Scope of Supervision:
None
Hazards:
If precautionary measures are not adhered to, this position could be susceptible to contact with infectious/communicable diseases, biohazard waste materials, needle pricks, etc.
Safety:
Triad Adult & Pediatric require that all employee work in a safe manner with regards to themselves and their co-workers. Any unsafe acts or condition are to be reported immediately.
Quality Improvement
Must understand and help enforce the meaning of quality improvement. “The combined and unceasing efforts of everyone-healthcare professionals, patients, and their families, researchers, payers, planners and educators-to make the change that will lead to better patient outcomes, better system performance and better professional development” (Batalden, 2007). Committed to promoting TAPM as a medical home and incorporating the core components of a Patient Centered Medical Home into your position daily.
1. Patient Centered
2. Comprehensive care
3. Team-based
4. Coordinated
5. Accessible
6. Focusing on Quality and Safety
