Summary

Patient Navigator at Baylor College of Medicine will coordinate and manage approximately 50 cases of AYASHCN with kidney or sickle cell disease in Year 1 and about 50 cases of AYASHCN with other chronic diseases in Year 2 in preparing for transition to adult care within the Harris Health System (HHS), including facilitating their successful application for the financial aid to receive HHS services; monitor electronic communication regarding patient medical information between Texas Children's Hospital and HHS; help create the Standard Operating Procedures Manual along with the TCH Liaisons; work closely with their counterpart Patient Navigator on this project based at HHS, meet at least weekly with the TCH Transition Planning Workgroup to discuss execution of the project, and bimonthly to monthly with the larger TCH-HHS Project Team to provide feedback, discuss progress, and identify barriers and develop solutions.

Job Duties

• Be aware of patients who are applying to receive PCP and/or subspecialty HHS services (through FAP or with Medicaid). 
• Monitors and documents appropriate transfer of patient information between TCH and HHS. 
• Follows patient through the transition from TCH to HHS, monitor and document that PCP and subspecialty appointments are scheduled and completed; help troubleshoot barriers to accessing services; maintain contact with patients for the purpose of collecting follow-up data. 
• Contributes to writing SOPs and recommend process improvements. 
• Collaborates with HHS patient navigator and HHS staff and TCH subspecialty staff (e.g., renal, sickle cell, rheumatology).  
• Attends and contributes to the Tuesday work meetings related to the EHF project, and Thursday at 11 a.m. meetings and take minutes. 
• Attends quarterly HCT meetings with renal, hematology, and rheumatology.
   

Minimum Qualifications

• High School diploma or GED.
• Four years of relevant experience.