Care Navigator

About the role

Join a team dedicated to making a difference in the lives of individuals and their communities. Our Culture Playbook guides us in how we interact, ensuring clear expectations, support, and commitment to positive outcomes.

Responsibilities

• Work closely with individuals to promote effective connection and collaboration to services.
• Identify and remove barriers to care by identifying critical resources and navigating health care services, insurance plans, and systems.
• Build working relationships, solve problems, direct to resources, and manage information.
• Coordinate to improve quality of care through the efficient use of resources and enhance outcomes.
• Act as an advocate and assist in coordination of care to minimize fragmentation of health care delivery systems.
• Gather insurance information, assist in navigating complex healthcare and insurance systems, assist in securing health insurance, complete paperwork for the sliding scale fee, complete referrals to care management services, and follow up with individuals until a warm hand-off to care management is complete.
• Identify and effectively utilize community resources to meet the needs of the member/family.
• Care across the healthcare continuum and optimize clinical and financial outcomes.
• Maintain a working knowledge of payer requirements, negotiate on behalf of the member for cost-effective, high quality services, and maximize the efficient use of resources.
• Serve as a liaison to providers, members, and families for coordination of services.
• Document all interventions using the Complex Care Management billable documentation.
• Work collaboratively as part of a team.
• Routinely engage with members and potential members in community settings to address barriers to care and directly facilitate service access.
• Conduct community-based resource identification and networking to establish and maintain strong partnerships with local organizations.
• Represent the organization at community health fairs, meetings, and events to promote services and identify individuals needing care navigation support.
• Provide safe and reliable transportation for clients to and from appointments, resource centers, and other essential services as required for care coordination.
• Build strong working relationships with internal and external partners.
• Support organizational priorities through adaptability and process improvement.
• Contribute to department goals by maintaining open communication and professional collaboration.
• Utilize Electronic Health Records and other systems for accurate and timely documentation.
• Participate in staff meetings, trainings, and other organizational development initiatives as required.

Qualifications and Attributes

• Excellent written, verbal and listening abilities.
• Willingness to establish effective working relationships with internal and external providers/resources.
• Ability to manage conflict, stress, and multiple simultaneous work demands in an effective and professional manner.
• Ability to work well independently, while collaborating with other team members.
• Ability and willingness to self-motivate, to prioritize, and change processes to improve effectiveness and efficiency.
• Adapts to changing program or organizational priorities.
• Knowledge of and appreciation for cultural diversity and low literacy issues in care provision.
• Computer literacy. Ability to navigate Electronic Health Records and other systems.
• Willingness and ability to travel locally and work in various community settings.

Education and Experience

• Required: Bachelor's Degree in Health and Human Services or related field, or NYS licensure and registration as a Registered Nurse and a bachelor's degree, or Bachelor's level education or higher in any field with five years of experience working directly with highly vulnerable populations (i.e. those with health, behavioral health, substance use issues), or a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) or equivalent experience in behavioral health, human services or other.
• Preferred: Master’s degree in a related education field may be substituted for one year of experience.

Physical Characteristics

• Must be capable to access all rooms in a 2-story home.
• Able to work in open space floor plan.
• Able to move throughout work day.
• Occasional lifting of >_25+ pounds.