Patient Advocate

JOB SUMMARY:

Under direction of the Nurse Manager of Value Based Care or Lead RN Care Manager, the Patient Advocate provides and facilitates communication of basic health information and performs clerical, clinical documentation, and other support services for patients in the Chronic Care Management (CCM) and Transitional Care Management (TCM) programs. He/She serves as telephonic and clerical support for the Care Management patients and provides services such as appointment scheduling and medical record retrieval. He/She provides basic social services and application assistance for patients as needed and is responsible for ensuring billing and documentation is complete for Chronic Care Management patients. The Patient Advocate also assists in the development and implementation of patient campaigns for health risk assessments, annual wellness visits, and other prevention strategies as designated by the Nurse Manager of Value Based Care, the Lead RN Care Manager as appropriate, as well as the Quality Improvement Manager.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Serves as the main point of contact with hospitals for the scheduling of patients post discharge and ER diversion.
• Uploads hospital records from hospital electronic medical record (EMR) to Athena for new admissions/discharges. Calls and faxes requests for inpatient and post-acute records from facilities when EMR access is limited or not obtainable.
• Assists the Transitional Care Manager (TCM) with coordinating new referrals for patients post discharge to ensure the specialist receives the referral, supporting clinical documentation, and authorization. Ensures the patient is given a timely appointment from the specialist and follows up after the appointment to ensure records are uploaded to the patient's Athena chart and placed in review to the Primary Care Provider.
• Assists with coordinating start of care with Home Health Agencies as needed.
• Serves as the point of contact for all Value Based Care patients that do not have an assigned care manager.
• Assists patients with appointment scheduling with the PCP, specialists, and testing facilities.
• Facilitates reminder calls for appointments, labs, and outstanding quality improvement measures.
• Interacts with respect and in a professional manner with patients, staff, and external customers.
• Completes telephonic campaigns for annual wellness visits, health risk assessments, and other prevention campaigns.
• Ensures billing is complete for all CCM care plans.
• Athena labeling maintenance: marking the charts of newly attributed VBC/DCE patients. Unmarks the charts of those termed/deceased patients. Maintaining CCM patient lists inside of the population health tool for newly assigned and termed patients.
• Completes the deceased and hospice patient workflows.
• Participates in pertinent meetings, workshops, seminars, and related forums as directed.
• Other duties as assigned and directed by the Nurse Manager of Value Based Care and/or the Lead RN Care Manager.
• Follows HIPAA and OSHA Standards and guidelines.
• Maintains HR compliance and procedures.

KNOWLEDGE/SKILLS/ABILITIES:

The Patient Advocate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.

A general knowledge of primary care practice, clinics, basic knowledge of legal and ethical standards for the delivery of primary care and medical terminology is required. Must have personal effectiveness and credibility, collaborative skills, communication proficiency and flexibility. Must be able to work independently and as a team player.

Knowledge of hospitals, specialists, and ancillary health services throughout the assigned community is preferred. Must be skilled in interaction with respect and in a professional manner with patients, staff and external customers. Excellent phone skills required.

Excellent verbal and written communication skills. Able to work independently and in a multidisciplinary team.

EDUCATION AND EXPERIENCE REQUIREMENTS

High school diploma or a GED is required. Minimum of 2 years medical clinic front office and/or medical assistant experience is required; or equivalent combination of education and experience as determined by the Nurse Manager of Value Based Care or Lead RN Care Manager. Basic knowledge of Medical Insurance is preferred.

Strong computer skills and proficiency in internet software and knowledge of Microsoft Office products is required. Able to effectively utilize an electronic health record. Athena EHR experience preferred.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.