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This position has the ability to work remotely on either a part- or full-time basis as determined by MMG leadership

Position Summary:

The Population Health Navigator II is embedded within the ambulatory practices to direct and assist patients and care givers with navigating the healthcare delivery system. The Population Health Navigator II provides services such as appointments, referrals, care coordination, community resources, and transportation to optimize their health supported by McLaren and its provider network.

This position works collaboratively with the providers, office-based clinical staff and MPP care coordination team to ensure patients have access to care and care coordination services.

Essential Functions and Responsibilities:

1.

Under the direction of the office provider(s), RN or MSW care coordinator, performs care coordination services for MPP including but not limited to the use of ADT systems, patient outreach for gap closure, AWV scheduling, enrolling in Care Management programs, scheduling follow-up care and preventive screenings to support physician performance with quality initiatives.

2.

Conducts initial patient screening for at risk patients based on standardized assessment tools and links patients with appropriate community resources or provides internal referrals to care coordination services.

3.

Provides timely discharge support to include scheduling PCP and Specialist appointments and ensuring the completion of diagnostic testing and helps patients overcome barriers to accessing care.

4.

Identifies and addresses potential patient barriers to care plan and medication adherence.

5.

Establishes trusting relationships with providers, patients and their caregivers while providing individualized support and encouragement.

Qualifications:

_Required_

+ Associate degree in health care or related field or equivalent certification such as CMA, Community Health Worker or Navigator

+ Five (5) years’ experience in healthcare setting serving complex coordination of chronically ill patients.

_Preferred:_

+ Bachelor’s Degree

+ Experience in a health plan or Physician Organization environment with Care Coordination, Utilization Management, disease management, and/or population health.

+ Motivational Interviewing or Patient Engagement Training