Community Health Navigator

Amerihealth Caritas•Washington, DC

9d•$64,300 - $87,700•Hybrid

About The Position

The Community Health Navigator establishes connections with a targeted member population, including some high-risk members, and serves as their primary ACFC contact. The role supports members through outreach calls and home visits, identifies social determinants of health (SDOH) needs, and coordinates basic care follow-up in collaboration with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations. The position helps members complete HEDIS, EPSDT, and plan requirements, address barriers to care, and build relationships with medical and dental providers. The role also develops and maintains relationships with community organizations, collaborates with internal departments and external agencies on health education and promotion programs, and educates members and their representatives about available benefits. The expected workload includes a moderate- or low-risk member caseload. The schedule is Monday through Friday, 8:30 AM to 5:00 PM, with four days on-site at the DC office and one day remote. Travel of up to 50% is required to meet members in assigned DC communities.

Requirements

Associate’s degree in Health Care, Human Services, or a related field, or equivalent work experience.
At least one year of health care experience in an office, clinic, or hospital setting, or human services experience.
Ability to travel up to 50% of the time to meet with members in assigned communities within DC.
Knowledge and understanding of medical terminology and disease processes.
Ability to effectively communicate preventive health and health management philosophies to members and agencies.
Comprehensive knowledge of Medicaid requirements and plan policies and procedures.
Knowledge of managed care.

Nice To Haves

Community-based care experience.

Responsibilities

Establish connections and act as the primary ACFC contact for a targeted member population, including some high-risk members, through home visits and outreach calls.
Identify members’ SDOH needs and address them appropriately.
Coordinate care by handling basic care follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations.
Inform members of actions required to fulfill HEDIS, EPSDT, plan requirements, and other referred outreach, using phone calls or home visits, and encourage compliance.
Help address members’ barriers to care and foster relationships with their medical and dental providers.
Develop and maintain relationships with new and established community organizations through phone, mail, email, or personal visits.
Collaborate with internal departments and external agencies to obtain data relevant to health education and promotion programs.
Educate members and member representatives about available benefits.