Community Care Navigator

Core Functions

• Works with the patient to coordinate services into or out of a care setting in order to obtain appropriate services and benefits in collaboration with providers and clinical staff.
• This includes facility referrals or tasking other departments, coordinating home health care, confirming arrangements, making physician or outpatient appointments.
• Confirms that referrals to specialists or appointments met the needs of the patient.
• Aids in patient navigation through the healthcare system by connecting the member with information or services.
• Bridges gaps between the member and the clinical team including but not limited to the following, connection to services, identifying social needs, addressing health literacy, cultural and social-class barriers.
• Reinforces activities of daily living and bridges necessary services to promote client health.
• As an integral part of the health care team, this position will participate in huddles, practice meetings, or hospital rounding to understand and adapt to the needs of the Primary Care team.
• This role is integral to understanding and adapting to the needs of the Primary Care team and patient as a liaison for case management services.
• Edicates internal members of the health care team on care management, managed care concepts, and community resources.
• Facilitates integration of concepts into daily practice.
• Works to bridge the gap between the Banner Plans and Network Division services and services available outside of Banner Case Management.
• Acts as the designated BPN representative within the community.
• Establishes and promotes a collaborative relationship with community agencies, physicians, payers, and other members of the health care team.
• Understands the role of PBN in providing care management services to members.
• Serves as a point of contact for inquiries and requests from community partners and community organizations.
• Creates and maintains an up-to-date external list of community contacts.
• Ensures the Health Plan websites have current and accurate information related to Outreach and Community Resources.
• Identifies potential outreach opportunities to inform current and potential members of community benefits and services or assists in the connection of members to community services when referred to by the multidisciplinary team or member services.
• Documents all interventions and patient related activities accurately and timely in the correct medical record.
• Utilizes EHR to provide outreach for patients in respective preventative care as well as support as part of the care team.

Minimum Qualifications

• Associates Degree or equivalent working knowledge in community relations, care management, or health care related field.
• Skill level typically achieved through a minimum of two years experience in community relations, care management, or health care related field.
• Must have reliable transportaton, valid driver's license, proof of car insurance and clean driving record.
• Require good oral and written communication, as well as listening skills to effectively interact pleasantly and calmly.
• Must possess computer skills, including proficiency with Office Suite.
• Must be able to effectively prioritize and make sound decisons following established department policies, procedures and standards.
• Able to multi-task in a fast-paced environment with frequent interruptions.
• Must posses the ability work cohesively in a team environment with multiple disciplines.

Preferred Qualifications

• Community Health Worker, Medical Assistant, or other certification preferred.
• One year experience with Medicaid, Commercial Insurance and/or Medicare preferred.
• Medical terminology and/or background preferred.
• Bilingual skills (English/Spanish) preferred.