Health Services Coordinator

Why naviHealth?

naviHealth is the result of over a decade of dedicated visionary leaders and innovative organizations challenging the status quo for PAC management solutions. We do healthcare differently and we are changing healthcare one patient at a time. How might you ask? By hiring talented clinicians, engineers, developers, and healthcare leaders to create and utilize cutting edge technology in order to provide the patient with the best level of care for the right amount of time.

Why Is This Role Critical? 

The Health Services Coordinator (HSC) serves as the main point of contact for healthcare providers, members that are receiving post-acute services as well as administrative (non-clinical) support for the remote clinical services team.  This role is responsible for providing direct support to the multi-disciplinary team to anticipate and plan for continuum of care and discharge needs.  In addition, the HSC for BPCI will work closely with the health care team (POA, healthcare facilities, physicians, social workers, discharge planners, etc.) to facilitate and coordinate all of the components of the safe discharge of patients from an inpatient location in a timely manner, to a less restrictive level of care. The HSC for BPCI is responsible for processing incoming faxes, inbound and outbound telephone communication, accuracy of database documentation and the completeness of the medical record and naviHealth database. The HSC for BPCI will be accountable for productivity, service and quality standards including but not limited to average speed of answer, hold time, refusal rate, abandonment rate, and processing speeds.

What you will be accountable for….

  • Manages inbound and outbound telephone communication in a professional manner and according to productivity and quality standards.
  • Processes inbound and outbound faxes and emails according to productivity and quality standards.
  • Reviews member benefits and eligibility.  Communicates this with the member, healthcare providers and/or naviHealth team as needed.
  • Enters in a timely manner and ensures accuracy of all required data into the naviHealth databases.
  • Informs designated naviHealth personnel when there are discrepancies or omissions in the medical record and/or naviHealth data base.
  • Communicates and documents authorization to appropriate naviHealth personnel, health providers and Health Plan, as indicated.
  • Completes administrative documentation for member records including but not limited to disenrollment, transitioning, creating auth shells, attaching medical records, recording and attaching opt-in/out documentation, generating member/provider letters, and contact attempts.
  • Assists in a smooth coordination of members care between health providers and the Health plan.  
  • Provides clerical support for team members, such as scanning, mailings, filing, copying and faxing as directed.
  • Sends alerts and notifications when appropriate to naviHealth field/care management staff as defined by departmental policy.
  • Assures transitional care notes and documentation are sent back to the Anchor Facility at the time of discharge on all members.
  • Ensures continuity of member care between health providers and the Health plan.
  • Provides telephonic follow up with beneficiaries for Case Management services to include post discharge and chronic condition management as indicated.
  • Triages inbound post-discharge member inquiries/requests and resolves if possible or escalates to appropriate naviHealth or health plan personnel. 
  • Attends naviHealth meetings as requested.
  • Adheres to organizational, departmental, compliance and regulatory policies and procedures.
  • Promotes a positive attitude and work environment.
  • Performs all other duties as assigned.

What you will need to be successful in this role….

  • High school diploma or GED required.
  • Excellent written and oral communications skills
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
  • Detail oriented.
  • Proficient with Microsoft Office applications including Word, Excel and Power Point.
  • Able to use various office equipment, such as: copier, fax machine, telephone and scanner.
  • Manual dexterity needed for keyboarding and other repetitive tasks
  • Must be able to work in a climate controlled, office environment.
  • Vision and Hearing must be adequate to perform job duties.
  • Ability to read and write in English in order to process paperwork and document information.

Physical Demands/Work Environment: 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.

  • Work is performed in a professional, business casual dress environment. Working extended hours may be required as needed
  • Ability to view screen and enter data into a computer, lap top or comparable hardware within a standard time period.
  • Ability to effectively communicate with Clients and team members including use of telephone or comparable communication device.
  • Ability to sit for extended time periods
  • Ability to work long hours with telephonic communication
  • Occasional lifting up to 10 pounds

The nice-to-haves……

  • Associate Degree or higher from an accredited college preferred.
  • Experience in healthcare setting strongly preferred.
  • Familiarity with medical terminology and HIPAA laws strongly preferred.
  • Bilingual language a plus.

About naviHealth

naviHealth is a pioneer in care transitions with a combined unprecedented 16 years of experience that uniquely positions us to manage and share risk with our partners.  As a Cardinal Health company, we provide clinical support alongside scaled technology and advisory solutions that empower health systems, health plans, and post acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes

Our Values

We care about the people we serve

We care about each other

We care about our communities

We embrace innovation

We like simple

NaviHealth ™ is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.