CareAtlas Inc

Care Navigator

• Build trusted relationships through consistent and compassionate outbound patient communication
• Manage an assigned patient panel of roughly 200 older Medicare patients and complete scheduled outreach and follow-up
• Review remotely transmitted readings such as blood pressure, glucose, and weight
• Identify readings or changes meeting established escalation criteria or differing from patient-specific parameters
• Promptly escalate concerns with readings, symptoms, history, and patient context needed by clinicians
• Help patients set up and use monitoring devices
• Reinforce clinician-approved care plans without providing independent medical advice
• Identify barriers involving transportation, cost, medication access, technology, or social support, and connect patients with approved resources
• Document interactions, outreach attempts, device support, and escalations accurately and promptly
• Follow CareAtlas privacy, security, documentation, and quality standards
• Participate in team huddles, training, and practical process improvement
• Receive and process new patient referrals from partner provider practices
• Confirm program eligibility, explain Remote Patient Monitoring and Chronic Care Management, and obtain and document patient consent
• Track referrals through enrollment or documented non-enrollment reasons and keep referring practices informed
• Follow defined protocols and escalate clinical questions to a Clinical Navigator or provider team