Patient Navigator – Outpatient Clinic Coordination

The Patient Navigator will play a critical role in ensuring smooth transitions of care by reviewing all Emergency Department (ED) and inpatient discharges to identify patients who meet criteria for outpatient clinic follow-up appointments. This position requires a basic knowledge of medical diagnoses and the ability to coordinate outpatient care efficiently.

The Patient Navigator will have direct patient interactions, as they will work closely with patients, physicians, nurses, and administrative staff to improve post-discharge continuity of care, reduce hospital readmissions, and enhance patient outcomes.

Essential Functions 

1. Patient Identification & Appointment Coordination:

• Review all ED and inpatient discharge summaries to determine which patients require outpatient follow-up appointments.
• Utilize hospital EHR systems to track discharge records and the medical necessity for out-patient follow-up care.
• Contact patients directly to schedule follow-up appointments and provide necessary instructions.
• Work with physicians and outpatient clinics to ensure timely scheduling based on medical necessity.
• Provide patients with information on their upcoming appointments, including location, transportation resources, and any required documentation.

2. Clinical Knowledge & Communication:

• Have a basic understanding of common medical diagnoses and post-discharge follow-up care needs based on medical diagnosis.
• Recognize conditions requiring urgent follow-up, including chronic disease management, post-surgical care, and specialty referrals.
• Collaborate with emergency department clinicians, hospitalists, nurses, case managers, and social workers to ensure smooth transitions from ED/inpatient to outpatient care.
• Act as a liaison between hospital departments and outpatient providers to streamline communication.

3. Patient Advocacy & Support:

• Address patient concerns and barriers to attending follow-up appointments, such as transportation, insurance, or scheduling conflicts.
• Educate patients on the importance of follow-up care to prevent complications and readmissions.
• Provide culturally sensitive patient education and support.

4. Documentation & Quality Assurance:

• Accurately document all patient interactions and scheduling efforts in the electronic medical record (EMR).
• Work with FHC Program Manager to track completion rates for appointments at the Family Health Center and report no-show trends to improve scheduling processes.
• Participate in hospital initiatives to improve outpatient follow-up compliance.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Minimum Education/Certifications

• High School Diploma or GED
• Associate’s or Bachelor’s degree (preferred) in a healthcare-related field such as:
  • Health Sciences
  • Public Health
  • Social Work
  • Nursing
  • Healthcare Administration

Minimum Work Experience

• At least 1 year experience in a clinical or administrative healthcare role (e.g., Medical Assistant, Scribe, Patient Access, Case Management, or similar).
• Basic understanding of medical terminology and common diagnoses.
• Strong communication and organizational skills with the ability to multitask.
• Experience working with electronic medical records (EMR) systems.
• Ability to work independently while collaborating with multiple departments.

Preferred:

• Prior experience in care coordination, discharge planning, or patient navigation.
• Background in medical assisting, nursing support, scribing, or case management.
• Certified Patient Navigator (CPN) or related healthcare training.
• Bilingual skills (preferred but not required).

Position Type/Expected Hours of Work:

• Onsite position with primary responsibilities in Emergency Department and Inpatient units.
• Monday – Friday (12:00 PM – 8:00 PM), with occasional weekend or holiday coverage as needed.

Physical Requirements:

Position requires prolonged periods of sitting and use of a computer and screen viewing throughout the working day.

Position will be required to stoop, bend, lift, and carry items weighing up to 25 pounds.