BPCI Patient Navigator Specialist in Huntington Park, CA at Pipeline Health Los Angeles

Date Posted: 4/27/2021

Job Snapshot

Job Description

Community Hospital of Huntington Park

Job Title: BPCI Patient Navigator Specialist 

City: Huntington Park / State: California    

Case Management

Day Shift

From 9:00 AM

To 5:30 PM


Job Description and Job Responsibilites

Title: BPCI Patient Navigator Specialist

Job Summary:

The Patient Navigator (PN) is an advocate, educator, and experienced guide for patients, as well as family members, through the continuum of care. The PN is responsible for facilitating the patient experience by guiding patients across the care continuum. The PN serves as the intermediary between the patient and the care provider or hospital resource, responsible for patient education, scheduling, care transition, discharge, and post treatment follow up. The PN works with the multidisciplinary care of the Bundled Payments for Care Improvement- Advanced (BPCI-A) patients with the goals of exceptional patient care, positive patient experience, and clinical outcomes. The PN improves the patient’s preparedness for post discharge care through education, review of clinical needs, and psychosocial support. The PN will Case Manage patients in post-acute facilities with a focus on initial assessment of skilled needs, and criteria for downgrading patients when skilled needs are no longer necessary.

Duties and Responsibilities:

  1. Manage the transition of patients across the continuum of care, or within a specific clinical setting including initial and on-going care coordination across all providers.
  2. Required to travel and visit patients in Skilled Nursing Facilities (SNF’s) to conduct on-going assessments of the patient’s progress through discharge.
  3. Ensure patients’ needs are met, understood and communicated to all team members.
  4. Arrange for a patient-interaction portion of the program when discharged home with a post-discharge follow-up via phone call or telehealth.
  5. Set benchmarks that can monitor progress while providing the flexibility to make needed adjustments to the care plan.
  6. Assist physicians in the coordination of patient care with other health care professionals, including non-affiliated community resources, if necessary. 
  7. Establishes quality care pathways to assess, amend, implement, and evaluate patient needs throughout the care process. 
  8. Follow-up with patient and other providers to discuss the patient’s response to treatment. 
  9. Provide accurate, on-going documentation of navigation and care coordination activities on each patient. 
  10. Facilitate communication between patients and healthcare providers. 
  11. Supports the patient and family in coping with the psychological aspects of their surgery (if indicated) and their primary diagnosis. 
  12. Serve as the primary point of contact between the patient, their family members, and the care team.
  13. Identify “at-risk” patients and ensures appropriate intensity of care by collaborating with all stakeholders.
  14. Provide community education to raise public awareness. 
  15. Assist in the collection and analysis of data, metrics, and other information to populate and manage the departmental scorecard. Communicates with senior leadership and physicians in terms pf progress, metrics, and issues, if any towards achievement of the required metrics and targets.
  16. Participate in the development, implementation, evaluation, and amendments of program(s) to improve quality, safety, patient experience and efficiencies.
  17. Effectively uses office management and telephone hardware and software.
  18. Identify the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).


Job Requirements

Minimum Education:

  • Graduate of an Accredited Registered Nursing Program, Nurse Practitioner Program or Physician Assistant Program.                


Preferred Education:

  • Bachelors’ Degree - preferred.
  • Patient Navigator Certification – preferred
  • Certified Case Manager (CCM) - preferred


Minimum Work Experience and Qualifications:

  • Five years of clinical experience as a Registered Nurse, Nurse Practitioner or Physician Assistant in an acute care setting.
  • Prior work experience as a Case Manager or Utilization RN.
  • Familiar with workflow in a SNF/post-acute facility environment.
  • Familiarity with the Patient Driven Payment Model (PDPM) reimbursement model.
  • Ability to communicate effectively verbally and in writing and strong listening skills.
  • Ability to work closely with Physicians and other interdisciplinary team members.


Preferred Work Experience and Qualifications:

  • Excellent computer skills to include excel, word, power point.
  • Patient education experience
  • Excellent organizational skills, with the ability to multi-task and prioritize work and execute deadlines.
  • Excellent communication and interpersonal skills. Employs empathy, patients, understanding, courtesy and kindness to all patients, their families, physicians, and other hospital staff.
  • Able to focus on long-term goals while managing day-to-day operations.
  • Exercise’s initiative, creativity, and courage to act in the best interest of the patient.
  • Ability to interact with stakeholders at all levels, including patients/ family, co-workers, providers, physicians, and administration.
  • Confident as a leader and building strong relationships.


Required Licensure, Certification, Registration or Designation

  • Current and valid California RN License or Physician Assistant License.
  • BLS Card