Premise Health is proud to partner with Quicken Loans and is seeking a Full Time Health Center NAVIGATOR, RN to work at a BRAND NEW Health and Wellness Center located in Detroit, Michigan . Premise Health is a leading worksite health and patient engagement company dedicated to improving the cost and quality of employee healthcare. We believe healthcare should be about helping people get, stay and be well. That’s our mission and it’s the foundation of everything we do. With more than 40 years of experience, Premise Health manages more than 500 worksite-based health and wellness centers across the country. The company serves more than 200 of the nation’s leading employers, including a significant number of the Fortune 1000. Purpose of Position The Health Center Navigator, RN advocates for patients and their families by answering questions and/or resolves issues regarding care/benefit plans and health care management such as communicating patient concerns to appropriate staff, coordinating referrals through insurance and other physician offices or specialists, and educating patients about their diagnoses through the treatment process. The Health Center Navigator, RN also does health center outreach like planning lunch-and-learns, promoting onsite wellness programs, and developing marketing and communication plans. Patients are introduced to a Nurse Navigator as early as possible to explain what they can expect from their treatment, help with scheduling appointments, provide information about support resources, and much more. The Nurse Navigator is an advocate and educator; dedicated to helping patients understand their diagnosis and care path. ESSENTIAL JOB FUNCTIONS Care/Benefit Plans Serves as the subject matter expert for clients’ benefits plan design and partners who utilize it Navigates the client’s network and their providers and interprets information for patients and their families Ensures benefits program complies with established policies, laws, and regulations Maintains awareness of changes in laws and regulations relating to employee benefits as impacting company benefits programs Assists with health center communications relating to benefits Researches a patient’s outstanding out of pocket expenses and resolves errors Resolves eligibility problems, incorrect claim charges and claim denials Coordinates information flow of benefits between dental, medical and other healthcare providers within the medical community. Assures correct application of specialist provider network status Care Coordination Fosters communications and coordinates benefits with insurance companies with the goal of creating a smooth patient centered experience Health Advocacy (RN) Collaborates with the patient, families and all providers in the decision-making process Resolves questions about whether services are condition specific or related to preventive care Communicates patients’ questions, complaints, and concerns to appropriate staff Coordinates referrals for patients through insurance and other physician offices or specialists Educates patients and their families about their diagnoses through the treatment process Navigates the diagnostic evaluation with patients Facilitates the transfer of medical records and lab results Facilitates the reviewing of test results with another physician for diagnosis confirmation Coordinates and arranges diagnostic tests Coordinates care for patients with complicated medical issues Engenders a positive health center experience for all members Greets and directs members and visitors Informs members about Premise Health’s available resources Responds to member’s needs quickly and appropriately and manages difficult or emotional situations Schedules appointments and enters appointment date and time into computerized scheduler May answer telephone and either respond to inquiry, direct caller to appropriate personnel, or initiate a triage slip for response by medical personnel Collaborates with Physician or other Licensed Independent Practitioner to arrange for further medical treatment, when needed. Identifies emergency situations and provides care within legal scope of practice. Maintains a clean and safe environment; follows infection control procedures Maintains patient privacy and confidential patient information Participates in follow up phone calls and follow up patient visits Member Engagement Conducts health center outreach (e.g. lunch and learns) May coordinate and promote onsite wellness programs for the client’s employee population in a single contract Assists in the development and implementation of marketing and communication plans; creates materials as needed including e-mail messages, articles and newsletters, online content and promotional materials (e.g. displays, flyers, bulletin boards) Collaborates with designated DCO and health center management to improve member engagement from goal planning through execution and after-action review Collaborates with health center staff to coordinate and promote health and wellness programs Works closely with third party health and wellness vendors Represents the health center, as appropriate, in scheduled or ad hoc employer meetings regarding health and wellness events or strategic initiatives Assist in the development, implementation and evaluation of health and wellness programs and services Foster and maintain positive, effective and long-term client/customer relations BASIC QUALIFICATIONS Education: Bachelor’s degree or equivalent work experience Certificate from an accredited Nursing School or Associate degree (A.S.) required; Bachelor’s degree (BSN) from four-year college or university preferred Currently licensed Registered Nurse in state of practice required Current training in AHA or ARC Basic Life Support for health care providers required; Advanced Cardiac Life Support may also be required based on contract scope of services Certification in Occupational Health Nursing, Certification in Emergency Nursing, or Certificate in Case Management preferred Experience: Experience with benefit policies and/or programs and answering employees’ benefits-related questions Experience with resolving conflicts or grievances; negotiating between parties 3+ years of non-clinical healthcare or wellness experience Knowledge and Skills: Knowledge of state and federal employment and employee benefit laws and regulations (e.g. RISA, COBRA, ACA, HIPAA, FMLA) and principles and practices of employee benefits and employee relations Knowledge of workplace health and safety concepts and OSHA regulations preferred Knowledge of principles and processes for providing customer and personal services Knowledge of computers and software programs to enter data and process information (e.g. inputting information into electronic health records) Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems Actively looking for ways to help people Ability to come up with unusual or clever ideas about a given topic or situation, or to develop creative ways to solve a problem Ability to generate or use different sets of rules for combining or grouping things in different ways Ability to come up with a number of ideas about a topic (the number of ideas is important, not their quality, correctness, or creativity) Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person Analyzing information and evaluating results to choose the best solution and solve problems Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts Developing constructive and cooperative working relationships with others, and maintaining them over time Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards Providing guidance and expert advice to management or other groups on technical, systems-, or process-related topics Translating or explaining what information means and how it can be used Developing specific goals and plans to prioritize, organize, and accomplish your work Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources’ information can be exchanged in person, in writing, or by telephone or e-mail Develop understanding of Epic's referral and scheduling capabilities, and available tools Develop understanding of where member populations live and work, as well as high-value providers and facilities in key geographies Proactively build relationships with community specialists, alongside other health center team members, to educate them on Premise and our expectations, facilitate streamlined referral access and information sharing Interact with Premise providers to understand referral needs Interact with members via multiple modalities (phone, email, in-person, video, etc) to identify appropriate referral target(s) Work with community specialists and members to schedule appointments and ensure bi-directional notes transfer Follow-up with member post-specialist visit, ensure member and specialist notes return to Premise, and coordinate ongoing care needs as appropriate Remain in close coordination with central MHM team as we evolve our MHM strategy, leveraging new tools and processes If you want to join a team of knowledgeable, compassionate, like-minded healthcare professionals, join Premise Health for an unlimited opportunity with the company that is changing the face and the place of the healthcare industry as we know it. We are an equal opportunity employer.