The Certified Patient Navigator is a  position that provides advocacy, information, enrollment and follow up assistance to CHP patients and community at large seeking health, wellness and ancillary services within the practices. The Certified Patient Navigator helps client/patients navigate Massachusetts Health Care reform including enrollment, reinstatement, billing, troubleshooting and the best customer service to all patients. This person will support CHP’s mission, vision, and values and will adhere to compliance protocols as well as CHP’s policies and procedures. Position is tied to grant funding and may not be converted into a permanent position.

Certified Patient Navigator Essential Duties and Responsibilities:

• Responds to incoming requests for assistance regarding the application and enrollment process by assisting old and new patients with expired or no insurance coverage to apply for available state subsidized programs, including Mass Health, Commonwealth Care, and the Health Safety Net as well as assistance regarding both the transitioning of health plans and the use of the Health Insurance Exchange website.
• Works with clients and outside agencies to ensure insurance is activated and duly covered.
• Attends community outreach and enrollment assistance events as time allows.
• Provides monthly reports and statistics of enrollment numbers and referrals as required for grant documentation.
• Keeps current on updates related to Mass Health and other state benefits and enrollment processes by attending conferences, forums, and receiving emails.
• Assists patients with various issues including those related to other medical groups, hospitals, and other social organizations.
• Works in collaboration with other organizations (BHS, Advocacy for Access, Berkshire Taconic Foundation) regarding mutual patients.
• Answers inquiries by phone and in person about eligibility guidelines, application requirements, and services covered.

Essential Skills and Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must initially pass and later maintain annual certification requirements as outlined by the State of Massachusetts.
• Must be able to understand and analyze billing information to develop processes re-engineering based on business needs.
• Able to research and interpret complex regulations.
• Ability to read, analyzes, and interprets common scientific and technical journals, financial reports, and legal documents; ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
• Ability to calculate figures and amounts.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• To perform this job successfully, an individual should have knowledge of Microsoft Office: Outlook, Word, Power Point and Excel.
• Position requires a level of specialized knowledge normally acquired through an Associate’s degree, or a combination of education and experience or 2 or more years of experience.

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