Care Navigator - Utilization Management (per diem)

People. Passion. Purpose.

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.

We are looking for a Care Navigator. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.

• This is a per diem role.  May work nights, holidays and weekends.  Approximately 10 hours per week.

Care Navigator - Utilization Management

Overall Purpose:

Under the supervision of the Medical Management Nurses, this position is responsible for assisting the nurses with Medical Management processes that do not require RN intervention, based on the scope of practice within the state. Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.

Education and Experience:

High School graduate required

Education as a medical assistant or nursing school student helpful

Strong problem-solving skills required

Experience in a managed care organization preferred

Knowledge of medical terminology required

Excellent communication skills with patients, providers, internal and external customers required

Must have excellent computer skills

Must have excellent organizational skills and ability to work independently

Knowledge, Skills and Abilities:

Friendly and compassionate disposition

Proficiency with computer, software programs (i.e. Microsoft Word, Excel) and internet required

Excellent communication and problem-solving skills

Excellent organizational and time management skills

Ability to learn quickly

Ability to handle a fast-paced environment and prioritize tasks based on importance

Strong interpersonal communication skills

Ability to work independently or as part of a team

Dedication to maintaining confidentiality of all patient records

Knowledge of medical terminology required Ability to demonstrate knowledge of vital signs and other clinical skills to obtain and maintain employment

Familiarity with EMR’s

Essential Functions:

Promote the mission, vision and values of P3 Health Partners

Coordinates patient care activities between UM and CM for assigned patient populations

Provides administrative functions to support UM and CM

Makes initial follow up telephone call to patients discharged from a facility, acute or post-acute, unless acuity requires RN to perform

Provides outreach and guidance to non-high-risk patients

Responsible for managing ER utilization report and interventions, per policy, to address inappropriate ER utilization

Assists Medical Management team in gathering additional clinical information when applicable

Supports the Medical Management team with appropriate referrals, claims history or any other clinical information necessary

Responsible for timely and accurate documentation in systems

Develops spreadsheets and other tools to support Medical Management team

Assists patients in obtaining / coordinating community and other resources

Work Location & Schedule

This role offers either an on-site or fully remote work arrangement. Candidates within a 50‑mile radius of a company office will follow our on-site schedule. Candidates located outside this radius will work remotely, with occasional travel to offices for meetings or key events.

Pay Rate range: $22.00 - $25.00 based on experience