Care Navigator - Utilization Management

People. Passion. Purpose. At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.We are looking for a Care Navigator. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Henderson, NV, then you should consider joining our team.Care Navigator - Utilization ManagementOverall Purpose: Under the supervision of the Medical Management Nurses, this position is responsible for assisting the nurses with Medical Management processes that do not require RN intervention, based on the scope of practice within the state. Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.Education and Experience: High School graduate requiredEducation as a medical assistant or nursing school student helpfulStrong problem-solving skills requiredExperience in a managed care organization preferredKnowledge of medical terminology requiredExcellent communication skills with patients, providers, internal and external customers requiredMust have excellent computer skillsMust have excellent organizational skills and ability to work independentlyKnowledge, Skills and Abilities:Friendly and compassionate dispositionProficiency with computer, software programs (i.e. Microsoft Word, Excel) and internet requiredExcellent communication and problem-solving skillsExcellent organizational and time management skillsAbility to learn quicklyAbility to handle a fast-paced environment and prioritize tasks based on importanceStrong interpersonal communication skillsAbility to work independently or as part of a teamDedication to maintaining confidentiality of all patient recordsKnowledge of medical terminology required Ability to demonstrate knowledge of vital signs and other clinical skills to obtain and maintain employmentFamiliarity with EMR’sEssential Functions:Promote the mission, vision and values of P3 Health PartnersCoordinates patient care activities between UM and CM for assigned patient populationsProvides administrative functions to support UM and CMMakes initial follow up telephone call to patients discharged from a facility, acute or post-acute, unless acuity requires RN to performProvides outreach and guidance to non-high-risk patientsResponsible for managing ER utilization report and interventions, per policy, to address inappropriate ER utilizationAssists Medical Management team in gathering additional clinical information when applicableSupports the Medical Management team with appropriate referrals, claims history or any other clinical information necessaryResponsible for timely and accurate documentation in systemsDevelops spreadsheets and other tools to support Medical Management teamAssists patients in obtaining / coordinating community and other resourcesWork Location & ScheduleThis role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.Hourly Pay Rate range: $22.00 - $25.00