Existing Patient Care Navigator

TMS Health Partners LLC • Houston, TX

2d • $50,000 - $70,000

About The Position

The Existing Patient Care Navigator supports established patients by ensuring information, documentation, and payor-related requirements are met to maintain continuity of care through ongoing treatment, while providing proactive, patient-centered communication across internal teams and external partners so patients feel supported and confident that their ongoing care needs are being addressed.

Requirements

• Demonstrated ability to accurately document, retrieve, and maintain information across multiple enterprise systems, including electronic health records (EHRs), customer relationship management (CRM) tools, and productivity platforms (e.g., Microsoft 365), while maintaining data integrity, timeliness, and adherence to documentation standards
• Ability to work effectively across multiple systems and tools, with demonstrated capacity to learn and apply new platforms, workflows, and processes as operational needs evolve
• Strong communication skills across a range of contexts, including patient interactions, third-party coordination (such as payors or referring providers), and collaboration with internal clinical and operational partners
• Demonstrated ability to gather, verify, and synthesize information accurately, including asking appropriate clarifying questions beyond scripted prompts to ensure completeness and reduce downstream rework
• Proven ownership and follow-through, shown by proactively tracking open items, meeting deadlines, escalating issues when appropriate, and seeking resolution rather than waiting for direction
• Ability to work effectively in a remote or hybrid environment, managing time, priorities, and workload independently while remaining aligned with team expectations and organizational goals
• Capacity to manage high-volume or complex interactions in a professional and consistent manner, including using established resources, escalation paths, and team support structures to maintain quality and reliability of work
• Experience supporting ongoing patient care workflows after treatment start, including coordination related to authorizations, renewals, extensions, scheduling changes, and issue resolution across clinical, financial, and operational partners
• Demonstrated ability to manage longer-term caseloads and follow-up work, including tracking open items over time, maintaining continuity of documentation, and supporting sustained patient access and financial outcomes

Responsibilities

• Ensure documentation, authorization, and payor requirements supporting continued treatment are met
• Ensure patient benefits and financial responsibility are clearly communicated, agreed upon, and appropriately collected or secured prior to appointment start to support patient readiness and continuity of care
• Monitor ongoing patient needs and take appropriate action to prevent delays, denials, or disruptions to care
• Communicate proactively with patients to provide updates, explain changes, gather updated information, and reinforce continuity of care
• Partner with providers, internal departments, and external organizations to resolve documentation or payor-related issues
• Review information for accuracy and completeness and determine appropriate next steps within established guidelines to address issues, or gaps impacting continuity of care
• Identify trends or recurring issues impacting continuity of care and escalate or address them as appropriate
• Maintain accurate documentation in the system of record
• Adhere to all compliance, confidentiality, and PHI requirements
• Meet defined service and performance expectations measured by SLAs and KPIs
• Support and cross-train with New Patient Care Navigators as needed
• Timely and accurately respond to appropriate requests for medical records, including those arising from subpoena or other legal proceedings
• Perform other duties as assigned to support the patient journey and operational priorities
• Responsibilities are consistent across regions, with flexibility in execution based on regional needs
• May be required to support patients outside assigned regions. Training and resources will be provided to ensure appropriate understanding of potential regional differences
• Performance evaluated based on continuity outcomes, problem resolution effectiveness, and SLA and KPI attainment
• Necessary training and support will be provided to enable successful performance and achievement of role expectations for assigned patients.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed