Tamheer - Care Navigator
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Key skills for this role
About the Role
The Care Navigator is responsible for operational care coordination and patient-facing communication within clinical programs.
Key Skills for This Role
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Job Description
The Care Navigator is responsible for operational care coordination and patient-facing communication within clinical programs. The role ensures timely follow-up, accurate dissemination of medical information, and seamless navigation of members through approved healthcare services in alignment with established clinical pathways and internal policies with a goal for members to have coordinated care throughout their journey and improve their health outcomes.
Patient Care Navigation & Case Coordination
- Act as the primary point of contact for members enrolled in clinical programs.
- Guide patients through approved care pathways, explaining service processes, requirements, and next steps.
- Coordinate internally to ensure timely processing of healthcare service requests (appointments, referrals, approvals).
- Maintain accurate documentation of all member interactions in the system.
- Collaboarte with healthcare providers, patients, and their families to facilitiate effective care management and improve health outcomes.
- Communication of Clinical Information and Patient Education
- Provide clear, accurate explanations to members regarding their medical service requests, approvals, and program enrollment status.
- Translate medical terminology into patient-friendly language while maintaining clinical accuracy.
- Escalate complex clinical inquiries to appropriate clinical supervisors or physicians when required.
- Facilitate communication between patients and healthcare providers to ensure continuity of care.
Operational Support To Clinical Programs
- Support the execution of clinical programs by tracking patient milestones and adherence to assigned pathways.
- Monitor enrollment, follow-up schedules, and required documentation.
- Assist in coordinating multidisciplinary interactions when required (e.g., providers, digital services, internal teams).
- Arrange necessary resources and services for patients, including referrals to specialists, community services, and support programs.
Service Request Monitoring & Follow-Up
- Track healthcare service requests from initiation to completion.
- Follow up with relevant departments (medical approvals, provider network, customer service) to prevent delays.
- Notify members of updates within agreed service level timelines.
Data Entry, Reporting & Documentation Compliance
- Ensure accurate entry of case notes, updates, and program-related activities into internal systems.
- Maintain confidentiality and compliance with healthcare data protection regulations.
- Support supervisors with basic operational reporting (e.g., caseload status, follow-up completion rates).
Patient Experience & Service Quality Support
- Address patient concerns related to care navigation within scope of authority.
- Identify recurring operational issues and escalate them to management.
- Contribute feedback to improve communication workflows and patient journey processes.
Skills
- Strong understanding of medical terminology and basic clinical pathways.
- Familiarity with healthcare authorization and service request processes.
- Proficiency in healthcare information systems and documentation tools.
- Clear verbal and written communication skills.
- Ability to manage multiple cases simultaneously with attention to detail.
Education
Bachelor’s degree in Nursing, Health Sciences, Public Health, or related healthcare field
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