COMMUNITY RESOURCE NAVIGATOR - WELLNESS WEST

Cook County•Chicago, IL

1d•Hybrid

About The Position

The Community Resource Navigator (CRN) works under supervision to support the provision of care coordination services for community-based members. These services are offered at the patient’s home, physician office, and/or hospital stay throughout Cook County. The CRN helps members navigate the healthcare delivery system, advocates on their behalf, and works to reduce barriers that interfere with the member’s ability to successfully interface with their medical home provider. This is a grant-funded position with an end date of 12-31-2026.

Requirements

High School Diploma or GED (Must provide proof at time of interview)
One (1) year of experience in a health care organization or community based social service agency performing health risk screenings, providing health education or supporting linkages to community-based resources is required
Valid Illinois Driver’s license and mandatory vehicle insurance as required in the State of Illinois (Must provide proof at time of interview)
One (1) year of experience with software and computers, i.e., data entry, word processing, appointment scheduling, Microsoft Office is required

Nice To Haves

Bachelor’s degree from an accredited college or university is preferred (Must provide official transcripts at time of interview)
Graduate of a Community Health Worker (CHW) Program is preferred
Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
Ability to track meetings, appointments, and emails in Microsoft Outlook
Ability to effectively prioritize work
Ability to meet deadlines

Responsibilities

Completes health risk screenings by asking members questions and documenting responses.
Provides education to members on how to increase the benefits of health system interaction (e.g., call before medications run out, call medical home prior to going to the ED for non-life-threatening issues, being prepared for provider visits).
Performs supportive tasks for members such as scheduling appointments, referrals to community-based resources, and providing directions on how to access services and care, and follows up with the member to close gaps in care.
Receives referrals to assist members in completing applications for programs like the Department of Rehabilitation Services (DRS), Department of Aging (DOA), Home Delivered Meals (HDM), etc., and mails/emails the member the confirmation to support coordination of care by case management.
Works under the direction of the Community Based Social Work Care Coordinator (CBSWCC) to link members to appropriate programs.
Supports efforts to locate members, including completing the Unable to Reach (UTR) process when necessary. This may involve calling medical homes, pharmacies, driving by the last known address to place outreach materials, conducting online searches, and contacting healthcare providers for updated demographic information.
Utilizes health risk screenings to determine escalation to licensed clinical staff as determined by Care Coordination policy.
Calls patients discharged from the ED to screen for improvement in symptoms and engagement of the ED treatment plan (e.g., prescriptions filled, appointments made). Refers cases to the Community Based Nurse Care Coordinator (CBNCC) for non-improvement in symptoms and incomplete after-care.
Interfaces with payers to validate authorization for required services.
Completes all education activities/training as required by state or accreditation standards. Attends training and receives certification to support patient education (e.g., diabetic education).
Provides lay education to members on self-management for chronic conditions consistent with the CRN role.
Coordinates care with the CBNCC or CBSWCC to escalate issues needing immediate attention.
Participates in Interdisciplinary Rounds as requested.
Documents all activities in the Care Management System according to Care Management policy and procedure.
Retrieves documentation from outside care organizations (e.g., history and physical, discharge summaries, medication list) to support effective transitions of care.
Travels to the homes of members and their sites of patient care to perform outreach and follow-up on care.
Protects Protected Health Information (PHI) and complies with Cook County Health Privacy Policy.
Consults information systems such as passport, managed care portals, or care management systems to assess member eligibility for service.
Performs other duties as assigned.