Patient Navigator 

Position Summary 

The Patient Navigator plays a critical role in supporting patients’ access to care, medications, and community resources. This position works closely with patients, medical providers, pharmacies, insurance companies, pharmaceutical manufacturers, and public and private assistance programs to reduce barriers to care and improve health outcomes. 

The Patient Navigator is responsible for helping patients navigate medication access and financial assistance programs, supporting appointment adherence and retention in care, and connecting patients with appropriate clinical and social support services. The Navigator serves as a patient advocate and liaison to ensure that medications prescribed by ASHwell medical providers are accessible, affordable, and obtained in a timely manner. 

Essential Duties and Responsibilities 

Patient Navigation and Care Coordination 

• Build supportive, respectful relationships with patients and assist them in identifying and addressing barriers to care. 

• Support patient appointment adherence, including outreach related to missed or upcoming appointments, as appropriate. 

• Work closely with the Intake team to promote patient engagement and retention in care. 

• Identify patient needs and make appropriate referrals to ASHwell Case Management and other internal or community-based resources. 

• Follow up with patients to ensure referrals, services, and medication access needs are resolved. 

• Communicate with patients regarding questions, concerns, barriers, and complaints and facilitate resolution when possible. 

• Provide culturally responsive, patient-centered support to individuals from diverse backgrounds and with varying health and social needs. 

Medication Access and Patient Assistance 

• Coordinate patient enrollment and renewal in pharmaceutical, public and private entitlement, and foundation-based patient assistance programs. 

• Assist patients with completing medication assistance applications, gathering required documentation, and navigating program requirements. 

• Coordinate with pharmacies, insurance providers, pharmaceutical manufacturers, and assistance programs to resolve medication access issues. 

• Initiate and track prior authorizations (PAs), insurer documentation requests, coverage issues, and other requirements necessary to obtain prescribed medications. 

• Support medical providers with prior authorization appeals and related documentation as needed. 

• Maintain current knowledge of medication assistance and funding resources for PrEP, PEP, HIV, HCV, and other biomedical prevention and treatment services. 

• Monitor medication access from referral through approval and dispensing, proactively identifying and resolving barriers that may delay treatment. 

• Maintain accurate tracking systems for medication access, assistance program status, and PrEP/PEP medication delivery or fulfillment. 

• Provide patients with accurate information regarding medication access, assistance programs, and prescribing-related resources within the scope of the position. 

Documentation and Quality Improvement 

• Ensure patient records contain timely, accurate, and complete documentation related to navigation, referrals, medication access, and assistance programs. 

• Document patient contacts, interventions, outcomes, and follow-up activities in the electronic medical record and/or other designated tracking systems. 

• Maintain organized tracking systems for outstanding patient needs, prior authorizations, applications, referrals, and medication access issues. 

• Maintain and distribute appropriate patient education and resource materials. 

• Participate in the implementation of clinic goals, objectives, policies, procedures, and quality improvement initiatives. 

• Contribute to data collection, reporting, quality analysis, and process improvement activities as assigned. 

• Identify recurring barriers to care and communicate trends or opportunities for improvement to appropriate clinic leadership. 

General Responsibilities 

• Maintain current knowledge of relevant healthcare programs, medication access resources, community services, and patient assistance programs. 

• Handle confidential patient information in accordance with ASHwell policies, HIPAA, and applicable federal and state requirements. 

• Maintain professional boundaries and demonstrate respect for patient autonomy, privacy, and dignity. 

• Promote collaboration and clear communication among clinical, administrative, and community partners. 

• Participate in staff meetings, training, and professional development activities as appropriate. 

• Perform other duties as assigned. 

Required Qualifications 

• High school diploma or equivalent required; additional education in healthcare, social services, public health, or a related field preferred. 

• Experience in patient navigation, care coordination, healthcare, social services, community health, or a related field preferred. 

• Exceptional customer service and interpersonal skills. 

• Strong organizational skills and the ability to manage multiple priorities, deadlines, and patient needs simultaneously. 

• Ability to develop and maintain effective systems for tracking patient issues and follow-up activities. 

• Strong written and verbal communication skills. 

• Ability to work effectively with diverse patients, healthcare professionals, community partners, and external organizations. 

• Strong computer proficiency, including Microsoft Office and web-based applications. 

• Ability to maintain accurate, timely, and confidential documentation. 

• Demonstrated ability to work independently while also contributing effectively as part of a multidisciplinary team. 

Preferred Qualifications 

• Experience working in HIV, STI, PrEP/PEP, HCV, infectious disease, or other community health programs. 

• Experience working with pharmaceutical patient assistance programs, insurance benefits, prior authorizations, or medication access programs. 

• Experience with electronic medical record (EMR/EHR) systems. 

• Experience working with community-based organizations and social service programs. 

• Bilingual or multilingual skills, particularly Spanish. 

• Knowledge of local and regional healthcare and social service resources. 

• Familiarity with health insurance terminology, eligibility requirements, and medication coverage processes. 

Core Competencies 

• Patient-centered service 

• Advocacy and problem-solving 

• Communication and active listening 

• Organization and attention to detail 

• Care coordination and follow-through 

• Cultural responsiveness 

• Confidentiality and professionalism 

• Teamwork and collaboration 

• Adaptability and initiative 

• Commitment to health equity and reducing barriers to care