Care Navigator

This is a fully remote position, open to applicants in United States.

📋 Description

• Daily processing of referrals to secondary care outside of Crossover Health, including specialists, imaging, community resources, and employer benefits.

• Maintain directories for specialists, community services, and employer benefits.

• Track referrals, ensure communication, and document appropriately to support continuity of care.

• Ensure that referrals are handled promptly.

• Assist in training MDs and CNs regarding the external referral process.

• Help with prior authorizations when necessary.

• Act as the primary contact between specialists, clinic physicians, and patients for care beyond Crossover Health clinics.

• Provide the clinical team with updates on active referrals.

• Utilize clinical judgment and critical thinking to assess provider type and referral urgency.

• Create complete referral packets and submit relevant clinical documents to specialists.

• Ensure that referral packets are received at specialist offices and that patients obtain timely appointments.

• Work within patient insurance benefits and consult benefit specialists to ensure high-quality, cost-effective care.

• Address downstream complications and prevent gaps in care.

• Maintain a professional interface with primary care MDs, RNs, and clinic Hosts.

• Contribute to the development of technology and service innovations for effective closed-loop referral communication and coordination.

• Perform additional duties as assigned.

⛳️ Requirements

• Minimum of 3 years of relevant experience (experience in a Primary Care setting is preferred).

• High school diploma or GED is required.

• Proficient in Google spreadsheets and/or Excel, along with database management and data tracking.

• Bachelor’s Degree or relevant medical experience is preferred.

• Experience in processing referrals for a medical group is advantageous.

• Creative, adaptable, and skilled at overcoming obstacles.

• Strong follow-through abilities and excellent task execution skills.

• Capable of managing ambiguity while problem-solving.

• Thrive in a fast-paced and ever-changing environment.

• Ability to work across multiple technology platforms simultaneously, applying clinical judgment and critical thinking in accessing and documenting patient referral information.

• Organized and accountable in a dynamic and constantly evolving setting.

• Strong communication, customer service, and interpersonal skills.

• Ability to connect effectively with patients, doctors, nursing staff, clinic staff, and technicians.

• Exceptional problem-solving and proactive problem-prevention skills.

• Motivation and commitment to assist others effectively.

• Ability to collaborate with a team to develop new and improved workflows.

• May require prolonged periods of standing, walking, and sitting.

• Occasional lifting and carrying of items weighing up to 50 lbs.

• Manual dexterity and hand-eye coordination.

• Full range of motion.

• Corrected vision, hearing, and speech within normal ranges.

• Must be able to communicate effectively with patients and team members.

🏝️ Benefits

• Eligible for 401K.

• Equal Employment Opportunity.

• Disability accommodation assistance.