Outpatient Navigator

PURPOSE STATEMENT:

The Outpatient Navigator supports continuity of care by guiding eligible patients transitioning from inpatient or residential behavioral health treatment into Partial Hospitalization (PHP), Intensive Outpatient Programming (IOP), or other community-based services. This role ensures timely, informed referrals; facilitates coordination among inpatient and outpatient departments; and provides education and support to patients and families regarding post-discharge services. With a deep understanding of levels of care, discharge workflows, and what differentiates Acadia’s outpatient programs, the Outpatient Navigator plays a vital role in increasing step-down engagement, reducing readmissions, and strengthening care transitions. The Outpatient Navigator may also help facilitate direct admissions to PHP/IOP programs.

ESSENTIAL FUNCTIONS:

Patient Engagement and Referral Coordination

• Own the full stepdown process—from patient identification to program admission

• Meet every eligible inpatient and review open direct admission inquiries to facilitate referrals to outpatient

• Educate patients and families on the value of continued care post-discharge and highlights of the hospital’s program (specialized tracks, support to address barriers to access such as transportation, etc.)

• Maintain multiple in-person check-ins during patient’s inpatient stay, including 1:1 discussions, facilitation of inpatient transitions/discharge groups, and participation in treatment team

• Support patients with outpatient orientation/program introduction, including completion of required admissions documentation and consent forms, and introductions to PHP/IOP leaders and therapists

Internal Team Collaboration and Communication

• Partner with other hospital departments to facilitate step-downs, including:

• Clinical services to confirm clinical appropriateness for outpatient and include outpatient in treatment plans

• Business office (BO) for benefits verification and copay clarifications

• Utilization Review/Management (UM) to secure necessary authorizations. Support with ongoing UM, as needed, including, but not limited to pre-certifications, renewal authorizations, denial appeals, and tracking days remaining.

• Business development and marketing for support to convey outpatient value proposition and key messages for patient engagement

• Outpatient Services to ensure capacity, program compatibility, and mutual awareness of discharge dates

• Participate in daily flash meetings to review emerging stepdown candidates, rationale for discharges not stepped down, and report out on day one PHP/IOP attendance for prior day’s step-downs

Performance Monitoring and Continuous Improvement

• Track step-down admissions and conversion rate and trends over time

• Identify barriers/opportunities to further enhance patient engagement and reduce readmissions

• Report weekly progress to facility CEO, COO, and Director of Outpatient Services

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Required

• High school diploma or equivalent required. Bachelor’s degree in social services-related field strongly preferred.

• Minimum of 2 years in behavioral healthcare setting (e.g., acute psychiatric hospital)

Preferred

• Licensed or license-eligible clinician (e.g., LCSW, LPC, LMHC, LMFT)

• Peer support specialist certification

• Experience with PHP and IOP levels of care, discharge planning, and/or utilization review