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**Job Type:** Regular

**Time Type:** Full time

**Work Shift:** Day (United States of America)

**FLSA Status:** Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The Population Health Navigator (PHN) is a temporary position (through December 2025) that collaborateswith primary care practice team members and population health team members to help improve the care of patients with hypertension (high blood pressure), diabetes, or those who are not up to date on their cancer screenings. The goal is to optimize our patients' health, well-being, and preventative healthcare. This role is primarily virtual/remote, with occasional opportunities for in-person work depending on program or practice needs.

In this role, the Population Health Navigator will reach out to patients via phone, the portal, and other modalities, to help educate patients, book follow up primary care visits and cancer screenings (mammograms), understand barriers to care. The PHN will partner with the population health team and practice team to think through creative ways to improve the care of our patients with hypertension, diabetes, and those due for cancer screenings. Additional duties may be assigned as needed to support program or organizational priorities.

Job Description:

Duties & Responsibilities including but not limited to:

1. Integrates into the primary care practices and with the Performance team at BILHPN, becoming a key member of the care and quality improvement teams to engage patients on their high blood pressure, diabetes, and cancer screenings.

2. Learn about HEDIS ambulatory quality measures and uses that knowledge to communicate information to the practice teams.

3. In close partnership with the BILHPN Population Health Specialist, acts as a key resource to practice(s) for the management of registries of patients that have chronic diseases (hypertension and diabetes) or due for cancer screenings (breast, colon and cervical cancer screening) ensure they have the required testing and medication management to promote optimal health and clinical outcomes. Helps population health team with pre-visit planning, reminders and processes on day of visit, and subsequent tests and referrals following visits to improve population health.

4. Works collaboratively with practice/providers to outreach patients via phone calls, mail, or electronic messaging to schedule appointments, screenings, and preventative tests, in close partnership with the BILHPN PHS overseeing the practice.

5. Provides an effective communication link between patients and the practice team.

6. Works with the population health team to identify and communicate best practice opportunities to practice team leaders, practices, clinicians and team members to help improve performance.

7. Participates in team meetings and decisions regarding data requirements for pro-actively managing the team’s panel.

Skills, Knowledge & Abilities:

1. Strong interpersonal and customer service skills required to communicate with patients, family members, physicians and other health care providers.

2. Willingness to learn medical terminology, medical recommendations, about specific chronic conditions as hypertension and diabetes, and specific cancers and their associated screening modalities (Mammograms, PAP smears, Cologuard, Colonoscopy, FIT testing)

3. Strong problem-solving and analytical skills preferred to identify areas of opportunity.

4. Demonstrates, after receipt of training, ability to use all applicable electronic systems including but not limited to a patient registry and the electronic health record (EHR)

5. Utilizes critical thinking and good judgement in performance of tasks.

6. Must possess good organizational skills

7. Proficiency with Microsoft applications including Word and Excel preferred

8. Understands and complies with highest standards of confidentiality. Familiarity with HIPAA regulations is required, and the PHN must consistently adhere to privacy and security standards related to protected health information (PHI).

Required Qualifications:

High School diploma or GED required.

0-1 years related work experience required. Enrolled in a college-level program in related field. Basic familiarity with computers. Ability to navigate at a basic level within web-based applications.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity** **Employer/Veterans/Disabled