Clinical Navigator

Title: Clinical Navigator

Reports to: Director of Managed Care

FLSA Status: Non-Exempt

Personnel Supervised: None

POSITION SUMMARY:

The Clinical Navigator will have direct and indirect patient care responsibilities. This position will work in collaboration with the clinical care team, including the Call Center, front check-in staff, nursing team, lab staff, and provider staff to ensure optimal outcomes for the patient's health. The primary responsibility of this position is to educate the CFHC staff in delivering safe, high quality, and efficient care to the patient population regarding all Managed Care health care screenings This position will focus on closing quality care gaps in conjunction with working special projects as assigned by DMC. This position will involve staff and patient involvement implementing an organization-wide multilevel program using evidence-based interventions. This position will also support the Managed Care Team in various capacities including education, training, and supporting HEDIS and STARS campaigns.

MINIMAL QULAIFICATIONS:

• Certification/Registration - Medical Assistants must be certified or registered and certified and registered Medical Assistants must maintain certification, OR
• Florida Licensed Practical Nurse (LPN)
• Current CPR
• High school diploma
• Clinical Experience (Substantial clinical experience may be used in lieu of CMA or LPN requirement)

EXPERIENCE:

Required:

• Minimum of 2 years of experience as a Clinical Medical Assistant and/or License Practical Nurse
• Experience with Microsoft Word, Excel, and PowerPoint
• Experience with electronic health records

Preferred

• Joint Commission, and/or quality management
• Knowledge of CDC Guidelines
• Knowledge of OSHA and HRSA standards for healthcare
• Knowledge of Managed Care guidelines
• Knowledge of HEDIS and STARS Measures
• Ability to work under tight deadlines and remain flexible
• Exceptional team, communication, and written/oral skills

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:

• Provides positive customer experiences with internal (co-workers) and external (patients and collaborative partners) customers
• Maintains awareness of CFHC's mission, vision, and overarching goal
• Maintains understanding and knowledge of, and remains compliant with CFHC's policies and procedures, particularly those pertaining to role
• Compliant with OSHA, HRSA, and Joint Commission regulations and standards
• Participates in QI team meetings, site meetings - when appropriate, and meetings for Moffitt Grant requirements, as well as other meetings when asked by supervisor
• Develops relationships with front office staff (AMA's/PCTAs), back office staff (LPNs, RNs, and providers), lab staff, call center staff, and QI team to identify smooth processes in the development of the screening process
• Work with Moffitt key partners to ensure key deliverables are met throughout the grant period
• Serve as the primary point of contact for the Moffit CARES-REACH (Colorectal Cancer Awareness, Research, Education and Screening-Rural Expansion, Access and Capacity for Health) research grant. Serve on the Moffitt Cancer Center Advisory Board
• Take part in the overall CARES-Reach strategic planning efforts and help to ensure that the research activities take into account the everyday practicalities of clinic fit, flow and functioning
• Motivate and enhance cancer screening awareness among providers
• Coach and navigate patients who do not respond to initial education by providers (do not return FIT kit, do not follow through with Mammogram or follow-up appointments for all cancer screening types)
• Facilitate communication between the research team, providers, and staff as needed
• Help to coordinate meetings at CFHC, and/or with Moffitt for effective communication for cancer screening activities
• Assist in directing the required data abstractions and coordinate implementation of clinic processes including EMR queries to identify baselines and detect screening outcomes for the organization
• Develop and implement Managed Care Campaigns to support HEDIS and STARS screenings and measures. Pull care reports , monitor and update care gaps.
• Works with Managed Care payors and collaboratereports,e managed care team to provide cross- functional support including patient outreach, communication.
• Complete other duties assigned by Director of Managed Care to support the Managed Care Team.

PHYSICAL REQUIREMENTS:

• Requires 80% or more time spent standing/walking.
• Independently mobile
• Ability to lift weights equivalent to what would be required when occasionally assisting and positioning patients, repositioning equipment and lifting supplies.
• Ability to adapt and function in varying environments of workload, patient acuity, worksites, and workshifts.

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.