Care Navigator Specialist

Community SeniorServ Inc • Santa Ana, CA

16h • $24 - $29 • Onsite

About The Position

Under the direction of Quality Assurance Manager, and The Director of, Enhanced Care Management will have overall strategic and operational responsibility for all program areas. The Care Navigator Specialist is primary role is to assist members enrolled in the ECM program. The Care Navigator Specialist assists members in obtaining the support they need to access healthcare and resources that impact their health. Navigators are non-licensed, non-clinical staff who collect information about economic barriers, concerns within healthcare systems, and basic needs, which include, but are not limited to, food, transportation, and material goods. They connect members directly to vetted community agencies and resources, which may involve community-based support. Navigators offer guidance and support to help members access CalOptima Health and other healthcare systems. They are highly trained communicators and subject matter experts, skilled in Motivational Interviewing, and are responsible for maintaining up-to-date knowledge of community resources. Navigators collaborate extensively within CalOptima Health and the larger community to overcome logistical barriers, enhance the quality of care, improve care continuity, and reduce healthcare costs.

Requirements

• Bachelor’s degree in social work, Psychology, Human Services, Nursing, Public Health, or a related field; equivalent work experience may be considered.
• Minimum of 2 years of experience in case management, care coordination, patient navigation, or related direct-service role.
• Experience working with diverse and vulnerable populations, including older adults, individuals with chronic conditions, or underserved communities.
• Knowledge of community resources, health and social service systems, and referral processes.
• Strong interpersonal and communication skills, with the ability to build trust and rapport with clients, families, and care providers.
• Demonstrated ability to conduct needs assessments, develop care/service plans, and monitor progress.
• Organizational and time management skills, with the ability to manage multiple priorities and meet deadlines.
• Ability to maintain confidentiality and comply with HIPAA and organizational policies.
• Strong problem-solving and advocacy skills to support clients in accessing needed services.
• Comfortable working both independently and collaboratively in a multidisciplinary team.
• Frequently remains in a stationary position and traverses locations.
• Constantly operates equipment, computers, or tools.
• Frequently extends body, arms or hands as needed to perform essential duties and responsibilities.
• Valid driver’s license, reliable transportation, and willingness to travel locally for home visits, community outreach, or appointments (if applicable).

Nice To Haves

• Bilingual (English/Spanish) strongly preferred or required depending on population served.

Responsibilities

• Caseload capacity will vary depending on population of focus
• Respond to referrals from primary worksite locations to support members with economic, logistical, and other non-clinical barriers to accessing care, following care plans and meeting goals.
• Outreach virtually or in person in care settings to establish resource needs, connect those resources, and follow up to determine if need is met.
• Escalate to and collaborate with clinical colleagues and care teams as appropriate (e.g. Primary/Specialty/Hospital, Social Work, FQHC, community supports)
• Participate in and consult to inter-disciplinary care teams to support complex members who have resource needs or logistical barriers. Address community resource needs for complex members/families in collaboration with interdisciplinary team.
• Research and connect with community agencies and relevant healthcare programs (e.g. CalAim community Support) to gain and maintain expertise in the roles, capabilities, and capacities of these agencies. Collaborate with Navigator team and maintain a shared regional resource library.
• Create collaborative relationships with staff across departments within CalOptima Health and externally promote collaboration and multi-system coordination. Participate in on-site events, clinics, and outreach initiatives as assigned.
• Support organizational initiatives as appropriate to resolve care access barrier (including, but not limited to, assisting members to align benefits, assisting in closing care gaps)
• Other responsibilities as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level