Patient Navigator Diabetes

General Summary of Position

Job Summary :

MedStar Health is looking for a Patient Navigator Diabetes to join our team at MedStar Georgetown University Hospital!

The Patient Navigator - Diabetes is responsible for coordinating care for patients enrolled in diabetes programs. Introduces potential participants and enrollees to the diabetes program and educates the patient and family about the program design, roles and responsibilities, and timeline.

Engages and enrolls participants, manages supply acquisition, and ensures access to needed technology. Patient registration, scheduling, check-in and check-out, referrals management, pre-certifications, authorizations, and working with patient records required.

Performs duties under the direction of the Senior Director and clinical team, adhering to program practice standards. As a patient advocate, guides and supports patients and families throughout their diabetes program experience.

Collaborates with program team and other health care team members to enhance coordination of care and positively impact patient outcomes and experiences.

Monitors patient outcomes and participates in quality improvement activities. Serves as the liaison for diabetes programs interacting with patients, providers, payors, suppliers, support organizations and members of the community.

Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses".

Apply today and learn how MedStar Health can be your next great career move!

Primary Duties :

Scans reports to identify high-risk (A1C>

9) patients for potential program enrollment. Sends standard message to PCP concerning findings with request to consider program referral.

Sends standard follow-up communication to PCP confirming patient decision to enroll or rationale if patient declines. Reviews referrals for inclusion and exclusion criteria and refers questionable cases to the CDCES.

Engages potential / actual diabetes program enrollees conveying program criteria, roles and responsibilities, timeline, technological requirements, patient visit preferences and payor / beneficiary authorizations and co-pays.

Communicates with insurance companies, patients, and providers regarding eligibility verification, benefits, co-pay and deductible status, and authorizations for office-based, telehealth and hospital services.

Ensures that eligibility and applicable authorizations are obtained prior to services being rendered; Documents insurance verification process and approvals according to program standards.

Onboard diabetes program enrollees : Obtains baseline information used by the care team for the development of the individualized plan of care.

• Delivers diabetes program materials per patient preference, electronically or in hard copy; Educates the patient on devices / glucose meter and remote patient monitoring (RPM) set up and testing;
• Screens for social needs, makes referrals and documents appropriately. Completes patient follow-up call to ensure engagement in services and resources;

Maintains accurate, complete, concise, and timely documentation in the electronic medical record. Registers patients in IDX.

Obtains and / or verifies complete demographic and insurance information from patient.

Schedules patient appointments in IDX to maximize capacity and patient availability / preferences. Confers with pharmacies and the Patient Services Coordinator to ensure patient blood glucose monitor / CGM supplies are obtained, coordinates and manages ongoing supply needs / delivery on behalf of the patient.

Monitors RPM dashboards for values outside of the acceptable range and escalates care.

Uploads validated device data into the EMR per routine / protocol. Sends timely and effective communications to interdisciplinary team members.

Identifies and recommends opportunities to enhance diabetes education, onboarding patient experience and retention. Reviews program data collection, tracking and reporting for completeness, escalates needs to Senior Operations Director.

Manages assigned case load and meets departmental / program productivity targets. Collaborates with the Patient Services Coordinator to ensure daily operational efficiency and patient gap closure.

Qualifications :

Associate degree, preferably in allied health or healthcare related field.

2 years of progressive customer service, medical / clinical office experience in a primary care, specialty care or social service setting.

Payor experience and previous experience with computerized registration systems, acquisition of durable medical supplies, and insurance authorizations preferred.

This position has a hiring range of $20.17 - $33.21