Job Description

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health!

Job Title & Role Description:

The Care Navigator serves as the primary point of contact for patients, ensuring a seamless and coordinated care experience. They will be responsible for facilitating communication between patients, their families, providers, and the Care Team, ensuring the delivery of comprehensive and continuous care. The Care Navigator will also handle patient registration, insurance verification, scheduling, follow-up support after visits, and offer general administrative assistance. This role is essential in optimizing patient care by coordinating with multiple healthcare providers, verifying insurance coverage, and supporting the broader Care Team to ensure smooth transitions and ongoing care.

Skills Required:

• 3+ years of experience in a healthcare practice, preferably in a patient representative or care coordination role
• High school diploma or GED required
• Experience with health insurance, including verification and understanding of medical terminology
• Strong organizational skills with the ability to handle multiple tasks in a fast-paced environment
• Excellent oral and written communication skills for clear and efficient communication with patients, providers, and the Care Team
• Strong attention to detail to ensure that all information is accurate and comprehensive
• Technologically savvy, including proficiency with EHR and related systems
• Ability to work independently in a remote setting while collaborating effectively with team members
• Multilingual capabilities preferred, but not required
• Knowledge of community resources in the applicable geographic area

Key Behaviors:

Patient-Centered Focus:

• Ensures patients receive the support and resources they need by acting as the main point of contact and providing ongoing communication to help them navigate the healthcare system.

Adaptability & Flexibility:

• Demonstrates the ability to change course and take on new tasks as needed, thriving in a fast-paced environment and responding to evolving patient needs.

Urgency & Proactive Action:

• Works with a sense of urgency to ensure all administrative, clinical, and coordination tasks are completed promptly, helping to expedite the delivery of care for patients.

Team Collaboration:

• Works cohesively with the Care Team, providers, and other stakeholders to ensure smooth care delivery and address patient needs effectively.

Strong Communication Skills:

• Utilizes clear, empathetic, and professional communication with patients, their families, and healthcare providers to ensure all needs are addressed and met.

Attention to Detail:

• Ensures all documentation and patient information is accurate, complete, and updated in a timely manner.

Competencies:

Care Coordination & Patient Advocacy:

• Demonstrated ability to facilitate the coordination of care across multiple providers and service levels, ensuring continuity and timeliness of patient care.

Insurance & Billing Knowledge:

• Experience in verifying insurance information, handling prior authorizations, and addressing insurance inquiries to ensure patients are covered and have access to necessary services.

Data Entry & Technology Proficiency:

• Ability to accurately enter data and navigate multiple healthcare technology systems, including EHRs and CRM platforms, to maintain organized and up-to-date patient records.

Problem-Solving & Critical Thinking:

• Ability to identify and resolve issues that may arise in patient care coordination, such as insurance eligibility, scheduling conflicts, or resource gaps.

Multitasking & Time Management:

• Capable of managing various tasks, such as scheduling appointments, patient follow-ups, and handling insurance inquiries, while maintaining attention to detail and deadlines.

Cultural Competency & Empathy:

• Ability to effectively engage with patients from diverse backgrounds, demonstrating cultural sensitivity and empathy to meet their individual needs.

Professional Boundaries & Confidentiality:

• Maintains appropriate professional boundaries with patients and team members while ensuring patient privacy and confidentiality in all interactions.

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.

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