Care Navigator

AltaPointe Health

About The Position

The Care Navigator assists patients with various aspects of their healthcare journey, encompassing clinical responsibilities such as coordinating care between healthcare providers and patients, assessing consumer needs, identifying goals for services, and providing linkage to community resources. The role involves monitoring consumer progress, educating patients on diagnoses and treatment options, providing emotional support, and facilitating communication within healthcare teams. Additionally, the Care Navigator advocates for patients, helps overcome logistical barriers to care (including transportation), participates in interdisciplinary care teams, and maintains knowledge of community resources. The position also includes administrative duties, clinical record keeping, caseload management, and adherence to company policies and productivity standards.

Requirements

  • Bachelor’s degree in a mental health discipline
  • Must be at least age 23
  • Maintain a valid verifiable driver license
  • Maintain a clear driving record
  • Knowledge of psychiatric disorders in the adult population (to be attained within six (6) months of employment)
  • Knowledge of developmental disabilities in the adult population (to be attained within six (6) months of employment)
  • Knowledge of substance use issues in the adult population (to be attained within six (6) months of employment)
  • Knowledge of chronic medical conditions in the adult population (to be attained within six (6) months of employment)
  • Knowledge of cultural diversity (to be attained within six (6) months of employment)
  • Knowledge of behavior management and crisis intervention (to be attained within six (6) months of employment)
  • Knowledge of available community resources and internal services (to be attained within six (6) months of employment)
  • Knowledge of Psychiatric Rehabilitation principles and /or Substance abuse treatment principles (to be attained within six (6) months of employment)
  • Knowledge of educational methods appropriate to adults with severe and persistent psychiatric disorders (to be attained within six (6) months of employment)
  • Knowledge of rules and regulations regarding appropriate benefit entitlements such as social security, Medicaid, and Medicare (to be attained within six (6) months of employment)

Responsibilities

  • Assists patient with paperwork including admissions, discharges, etc
  • Coordinates care between healthcare providers and patient
  • Ensure treatment providers have the results of screeners completed at intake and as indicated
  • Demonstrates the ability to assess the consumer’s needs utilizing the SUN-R/HSNA
  • Identifies goals and plans for appropriate services
  • Provides appropriate linkage to community resources
  • Monitors consumers to secure placement in the least restrictive environment
  • Provides ongoing monitoring of consumers’ progress and needs as assessed in the SUN-R/HSNA
  • Assists patients in connecting to primary healthcare
  • Assists patients in connecting with benefits specialist
  • Assists patients in connecting to appropriate therapists
  • Assists patients in referrals to TCM, IPS, Day Programs
  • Educates patients about their diagnoses, treatment options, and medications
  • Provides emotional support throughout the healthcare process
  • Facilitates communication between patients and healthcare teams
  • Conducts follow-up after hospital admissions to ensure proper care coordination
  • Connects patient with available community resources and services
  • Advocates for patient to ensure high-quality care
  • Helps patient overcome logistical barriers to accessing care to include assisting with transportation arrangements for medical appointments
  • Participates in interdisciplinary care teams to support complex cases
  • Maintains knowledge of community resources and healthcare programs
  • Coordinates implementation of internal services
  • Assesses social drivers of health to assist in reducing disparities
  • Provides ongoing monitoring of consumers’ progress and needs with the patient
  • Provides training of basic living skills to improve consumers' quality of life and to help enable them to be able to maintain in the least restrictive setting
  • Evaluate the patient for needed changes in Risk Levels
  • Evaluates the consumer for discharge planning
  • Effectively collaborates with the treatment team members and outside sources in the delivery of case management services
  • Effectively demonstrates the application of adult specific competencies
  • Seeks clinical supervision and consultation as needed
  • Accepts and employs suggestions for improvement
  • Actively works to enhance care management skills
  • Document interactions with patients when needed
  • Documents within Avatar appropriate follow-up and provision of linkage to services
  • Courteous and respectful attitudes towards patients, visitors, and co-workers
  • Treats patients with care, dignity, and respect
  • Respects patient’s privacy and confidentiality
  • Is pleasant and cooperative with others
  • Personal values don’t inhibit the ability to relate and care for others sensitive to the patient’s needs, expectations, and individual differences
  • Effectively manages caseload based on patient needs and staffs with supervisor regularly
  • Meets AltaPointe productivity standards
  • Actively participates in Performance Improvement activities
  • Actively participates in AltaPointe committees as required
  • Follows AltaPointe policies and procedures
  • Attend to required in-service training and other workshops
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