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Form of workJob Description
Job Summary:
The Care Navigator partners closely with hospital discharge planners and PCP practices to mitigate the Medicare hospitalized patients risk of readmission post discharge. They are the bridge and key data insights gather of the patient's clinical experience during the patient's hospital stay experience. This role will compile all insights learned from the Hospital Discharge Planner (HDP), medication reconciliation completed by Walgreens RPh, and the scheduled 7 day post discharge visit in an early discharge summary. This role will be the telephonic connection with HDP, PCP practices, and patients assisting with risk reduction and mitigation of readmission risk of assigned Medicare patients.
Job Responsibilities
External Basic Qualifications
Preferred Qualifications
Job Summary:
The Care Navigator partners closely with hospital discharge planners and PCP practices to mitigate the Medicare hospitalized patients risk of readmission post discharge. They are the bridge and key data insights gather of the patient's clinical experience during the patient's hospital stay experience. This role will compile all insights learned from the Hospital Discharge Planner (HDP), medication reconciliation completed by Walgreens RPh, and the scheduled 7 day post discharge visit in an early discharge summary. This role will be the telephonic connection with HDP, PCP practices, and patients assisting with risk reduction and mitigation of readmission risk of assigned Medicare patients.
Job Responsibilities
- Engaging with Hospital Discharge Planners and PCP Practices
- Collect and document all required data on patients admitted or recently through discharge from the hospital to prepare for a PCP visit within 7 days of discharge.
- Responsible for communicating with Hospital Discharge Planners, Utilization Managers, PCPs or patients making incoming calls with questions and or returning messages for this program.
- Provide outreach to patients to check in on non clinical issue resolution and escalation of issues that may arise impeding post discharge PCP visit. Escalate concerns to PCP practice or Walgreens management when appropriate.
- Follow up with patients to confirm participation in 7 day post discharge visit, mitigate barriers as arise, and reschedule as applicable.
- Troubleshoot medication access issues and facilitate medication related refills (refill per protocol, bridge refills by standing order). As needed, coordinate medication support services offered by retail pharmacies (med sync, med delivery, access issues, etc.).
- Support Walgreens Health RPh as needed with medication reconciliation for post acute patients.
- Prepare all patient data insights learned from Hospital Discharge Planners, including Walgreens Health RPh medication review at discharge in summary report to PCP practice with scheduled post-discharge appointment.
- Collaboration with Internal and External Teams
- Recognize and respond appropriately to urgent or emergent situations per protocols, perform basic triage per specific procedures, refer to internal and external teams as appropriate per protocols.
- Build and facilitate communication and coordinate services between providers, clients, and supervisors, work collaboratively and effectively within multidisciplinary teams.
- Communicate effectively and persistently when contacting outside provider offices, hospitals, etc.
- Support the team in expansion of services and programming to support our risk contracts through developing or updating procedures and job aids and providing training and support on new procedures as applicable.
- Explain the Post Acute Care Support program, describe, and serve as a resource for internal and external colleagues with related questions on the program as it applies to PCP practices, patients, and hospital discharge planners.
- Triage any out of scope questions to Walgreens Health manager.
- Quality Assurance and Compliance
- Participation in process improvement discussions to help achieve efficient workflows and enhance quality of patient care.
- Document activities and outcomes in an effective manner consistent with organization's policies and procedures.
- Engage in continuous learning cycles to capture best practices for serving members through the Post Acute Care Support program and continuously expand knowledge and understanding of community resources, services, and programs available to assist patient's wellbeing success.
- Complete and maintain internal learning, development and safety training.
- Identify and apply appropriate role definition and skilled boundaries, maintain confidentiality of member engagements and records, adhere to organization's work practices for remote work.
About Walgreens and WBA
Walgreens (www.walgreens.com) is included in the U.S. Retail Pharmacy and U.S. Healthcare segments of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), an integrated healthcare, pharmacy and retail leader with a 170-year heritage of caring for communities. WBA's purpose is to create more joyful lives through better health. Operating nearly 9,000 retail locations across America, Puerto Rico and the U.S. Virgin Islands, Walgreens is proud to be a neighborhood health destination serving nearly 10 million customers each day. Walgreens pharmacists play a critical role in the U.S. healthcare system by providing a wide range of pharmacy and healthcare services, including those that drive equitable access to care for the nation's medically underserved populations. To best meet the needs of customers and patients, Walgreens offers a true omnichannel experience, with fully integrated physical and digital platforms supported by the latest technology to deliver high-quality products and services in communities nationwide."
External Basic Qualifications
- Strong interpersonal and customer service skills with a demonstrated ability to interact professionally with culturally and educationally diverse patients, and all levels of clinicians.
- High school diploma or equivalent
- At least 1 year of experience as care coordinator, clinical customer service, medical assistant, LPN, pharmacy technician, and or other related healthcare experience
- Willing to travel up to or at least 5% of the time for business purposes (within state and out of state).
Preferred Qualifications
- Preference will be given to Ohio based residents.
- Bachelors in health sciences or related field or health care background with valid national certification (ex certified pharmacy technician, medical assistant, LPN, etc).
- Physical requirements adequate to perform the job responsibilities telephonically.
- Experience coordinating care in populations that live with chronic complex conditions and health disparities.
- Proficiency in electronic medical records, pharmacy computerized systems, and Microsoft Office Product Suite.
- Experience in an ambulatory care setting with taking medication history.
- In-depth knowledge of prescription drugs, disease states, and health plan formulary management techniques.
- Basic understanding of chronic disease and biometric monitoring for member self care (e.g., weights, blood pressures, pulse oximetry, diabetes blood sugars, etc).
