Community Health Navigator

About the Role

The Community Health Navigator focuses on engaging members through outreach and in-person visits, identifying and addressing Social Determinants of Health (SDOH) needs, improving access to healthcare services, and supporting members in navigating available benefits, community resources, and promoting preventive care. This role reduces barriers to care and connects members to programs that support their overall health and well-being.

This is a remote, field-based role with approximately 75% travel required throughout the Lafayette (Region 4), Lake Charles (Region 5), and Alexandria (Region 6) service areas to meet with members in hospitals, homes, or community locations. The associate must be located in the state of Louisiana (LA).

Responsibilities

• Establish connections and serve as the primary contact for a targeted member population, including high-risk members, through home visits and outreach calls.
• Identify Social Determinants of Health (SDOH) needs and address them using available resources, including SDOH assessments, to determine eligibility for the state’s Healthy Opportunities Pilot program (HOP).
• Coordinate care by handling basic follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based healthcare providers, and other organizations.
• Inform members of required actions to fulfill Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), and Plan requirements via phone calls or home visits, encouraging compliance.
• Assist in addressing members’ barriers to care and foster relationships with their providers.
• Develop and maintain relationships with new and established community organizations via phone, mail, email, or personal visits.
• Collaborate with internal departments and external agencies to obtain data pertinent to the success of health education and promotion programs.
• Provide education to members and their representatives regarding available benefits.

Requirements

• Associate’s degree in healthcare, human services, or a related field, or 2+ years of equivalent experience in community outreach.
• Bachelor’s degree preferred.
• 2 years of experience in healthcare or managed care in an office, clinic, or hospital setting.
• Community-based care experience required.
• Previous experience presenting health education materials to individuals and small groups.
• Knowledge and understanding of medical terminology and disease processes.
• Comprehensive knowledge of Medicaid requirements, policies, and procedures.
• Valid driver’s license, car insurance, and reliable transportation required.

Skills & Abilities

• Strong understanding of SDOH and their impact on health outcomes.
• Knowledge of Medicaid programs, MCOs, and health plan operations.
• Familiarity with HEDIS, EPSDT, care management, and preventive health initiatives.
• Working knowledge of medical terminology, disease processes, and healthcare delivery systems.
• Ability to educate, motivate, and engage diverse member populations.
• Strong problem-solving and critical-thinking skills to assess member needs and identify solutions.
• Excellent verbal, written, and interpersonal communication skills.
• Ability to build productive relationships with members, providers, community organizations, and internal stakeholders.
• Strong organizational skills to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Outlook, Word, Excel, Teams, and SharePoint.
• Ability to work independently in a field-based environment while collaborating with remote teams.