Care Navigator, BH Specialist

Position Summary

The Care Navigator Behavioral Health Specialist (CNBHS) provides direct outreach and support to behavioral health patients and their families to address complex social determinants of health (SDOH) needs that negatively impact health and wellbeing. The CNBHS offers outreach and case management to promote compliance with treatment plans and connect patients to community resources supporting SDOH needs.

Essential Duties & Responsibilities

• Work collaboratively with the BHC to assess SDOH needs (e.g., food, financial, housing, legal) and connect patients to community-based agencies for assistance.
• Provide referral bridging to access mental health services internally and externally; help coordinate care with healthcare providers.
• Research and maintain a comprehensive community resource database for behavioral health services; improve provider and extended CN team knowledge on community resources.
• Provide case management support for an active caseload of behavioral health patients; conduct regular outreach to promote treatment plan compliance and act as liaison to the BHC.
• Administer behavioral health screening tools (PHQ-9, GAD-7) under the direction of the BHC and after completing training.
• Aid patients with form completion to access community resources and benefits when literacy or language barriers exist.
• Help patients navigate services provided by third-party agencies such as Inspectional Services, Massachusetts Commission for the Blind and Deaf/Hard of Hearing, Senior Services, Transportation Services, and homeless shelters.
• Collaborate with legal service agencies and educate patients about their rights as tenants and workers.
• Support direct service programs such as Cradles to Crayons and Food Pantry services as needed.
• Participate in supervision meetings with the collaborating BHC.
• Participate in professional development and team trainings focused on community resources and the intersections of social justice and community health work.
• Serve as a liaison between NeighborHealth and community behavioral health agencies.
• Assist with training and orienting new Care Navigators.
• Maintain timely and accurate documentation in Epic (telephone encounters and CRM).

Additional Responsibilities

• Maintain excellent punctuality and attendance.
• Demonstrate teamwork, self-direction, and self-motivation; solve problems independently or seek consultation when appropriate.
• Display outstanding customer service skills when interacting with all NeighborHealth customers following the ACE model.
• Adhere to all NeighborHealth and departmental policies and procedures.
• Participate in required departmental activities and meetings.
• Perform other related duties as assigned.

Organizational Competencies

• Read, understand, and comply with Standards of Conduct, JCAHO policies, CMS PACE Program Regulations, applicable state regulations, NeighborHealth policies, and all employment laws.
• Safeguard the confidentiality of all patient and employee information.
• Follow safety policies and procedures (e.g., fire safety, electrical safety, body mechanics, ergonomic safety).

Knowledge, Skills, and Abilities Required

• Education: Bachelor’s Degree required.
• Experience: 1–2 years in a direct service role; experience with underserved populations is preferred.
• Skills/Abilities: Strong second language skills preferred (Spanish). Excellent organizational and time management skills. Ability to multitask effectively.

Licenses/Certifications Required

• Licensure/Certification as required.
• CPR certification required.