Crossover Health
Healthcare
CareNavigator
“Care Navigator at Crossover Health. Skills: Care Navigation, Referral Management, Coordination of Care, Communication. Daily processing of referrals to secondary care, outside of Crossover Health (specialists, imaging, community resources, employer benefits).. Maintain high quality specialist, community service, and employer benefit directories.”
What You'll Achieve.
demonstrated high-quality care; patient experience; practice efficiency; cost effectiveness; service level consistent with Crossover Health standards; continuity of care; timely submission of referral packets; timely patient appointment; most high quality and cost effective care; gaps in care are averted
Industry & Context.
Able to handle ambiguity when problem solving; Excellent problem solving and problem preempting skills; Troubleshoot downstream complications or unexpected circumstances
May require standing, walking and sitting for extended amounts of time., Occasionally lift and carry items weighing up to 50 lbs., Manual and finger dexterity and hand-eye coordination, Includes full range of body motion., Requires corrected vision, hearing and speech within normal ranges., Must be able to effectively communicate with patients and team members.
What They're Looking For.
Must Have
At least 3 years of applicable experience, High school diploma/GED required, Proficient working with Google spreadsheets and/or excel, database management, data tracking
Nice to Have
Bachelor’s Degree or relative medical experience, Experience processing referrals for a medical group, Creative and flexible and effectively manages obstacles, Excellent follow-through and have task execution skills, Able to handle ambiguity when problem solving, Thrive in a fast-paced and rapidly changing environment, Ability to work in multiple technology platforms simultaneously, using clinical judgment and critical thinking in accessing and documenting information that pertains to each patient’s referral process, Organization and accountability within a fluid and constantly changing environment, communication, customer service and people the ability to connect with all stakeholders (patients, doctors, nursing staff, clinic staff, technicians), Excellent problem solving and problem preempting skills, Willingness and drive to go the distance to help, Work with a team to create new and improved workflows that build upon our new centralized referral management product
What You'll Do.
Daily processing of referrals to secondary care
outside of Crossover Health (specialists
Maintain high quality specialist
and employer benefit directories.
Maintain ongoing communication
and appropriate documentation on referrals to ensure continuity of care.
Ensure that referrals are addressed in a timely manner.
Assist with prior authorizations as needed.
Be the single point of contact between specialists
the clinic physicians
and the patients when care is needed outside of a Crossover Health clinic
and provide updates as appropriate to the clinical team to ensure visibility into active referrals.
Use clinical judgment and critical thinking to discern and refine the correct provider type and stratify the urgency of the referral
in consultation with clinical team members when necessary.
Generate a complete referral packet and ensure timely submission to the specialist of the appropriate clinical documents to support the request for the referral (pertinent clinical notes
historical medical records
Ensure the arrival of the packet at the specialist office and a timely patient appointment.
Work within the parameters of the patient insurance benefits and consult with benefit specialists as needed for the most high quality and cost effective care.
Troubleshoot downstream complications or unexpected circumstances so that patient needs are placed first and gaps in care are averted.
How You'll Work.
Team & Collaboration
Assist with training relevant stakeholders (MDs and CNs) on the external referral process.; Interface regularly in a professional and collegial way with primary care MD’s and RN’s and clinic Hosts.; Assist in the development of technology and service innovations to ensure a closed loop system of communication and coordination with our Crossover providers and network specialists.; Work with a team to create new and improved workflows that build upon our new centralized referral management product.
Communication Scope
communication; customer service; people skills; ability to connect with all stakeholders (patients, doctors, nursing staff, clinic staff, technicians)
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