General Description of the Job Class The Patient Navigator assumes responsibility and accountability for the management of resources through interdisciplinary collaboration to achieve optimal patient outcomes.
Duties and Responsibilities of this Level The Outpatient Palliative Care Patient Navigator will facilitate a seamless model of access and care benefiting patients, participating physicians, and family members. This role will: a. Initiate telephone contact for all identified high - risk patients for readmission post discharge to reduce occurrence of new appointment no - shows. b. Assess/identify barriers to services and collaborate with the interdisciplinary care teams including case management to address barriers through the development of an alternative management plan (e.g. home - based palliative care, bridge program, or hospice). c. Follow - up and screening of all clinic no - shows to identify unmet needs and/or need for additional community services, hospice transition if indicated etc. d. Provide symptom management in collaboration with the clinical team. e. Assess patients for psychosocial distress and referral to a medical social worker or counselor if support that is more intensive is needed. f. Coordinate weekly rounds for selected high - risk patients in follow - up. g. Function as a consultant and educator for staff and patients/families by providing education, support, and resources for care. h. Participate as a member of the interdisciplinary palliative care team, effectively interfacing with providers across the continuum to ensure patients have an appropriate plan of care including but not limited to follow - up appointments, referrals, and medication management. i. Monitor and report outcomes; thereby identifying areas for improvement in processes. j. Provide administrative support for the palliative care outpatient practice such as prior authorizations, facilitation of prescription refills, and management of the outpatient consultation pager. k. Perform other related duties incidental to the work described herein.
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
Education Bachelors degree in a health - related field required. Masters degree a health - related field preferred.
Experience Three years of experience in patient education, nursing, planning, case management, or similar experience.