Health Journey Specialist, Full-Time

CAMERON HEALTH•Angola, IN

20d•Onsite

About The Position

The Community-Based Wellness Navigator serves as a vital connector between healthcare providers, community-based organizations, social service agencies, and individuals seeking to improve their health and well-being. This role helps bridge gaps between clinical care and community resources to reduce fragmentation of services, improve access to care, address social drivers of health, and support better health outcomes at a lower overall cost of care. The Community-Based Wellness Navigator proactively identifies barriers to health and wellness, connects individuals to appropriate community programs and healthcare services, facilitates referral completion, and supports care coordination across multiple settings. Working collaboratively with healthcare providers, community organizations, public health agencies, and social service partners, the navigator promotes whole-person care, health equity, patient engagement, and population health improvement.

Requirements

Minimum of two years of experience in community health, care coordination, patient navigation, social services, population health, public health, or related field.
Knowledge of community resources, healthcare systems, and social service programs.
Strong communication, relationship-building, and problem-solving skills.
Ability to work effectively with diverse populations and community partners.
Proficiency with electronic documentation systems and Microsoft Office applications.

Nice To Haves

Associate's degree in Nursing, Community Health, Healthcare Administration, Human Services, or related field; or equivalent experience.
Registered Nurse preferred.

Responsibilities

Serve as a liaison between healthcare providers, community-based organizations, employers, social service agencies, and individuals receiving services.
Connect patients and community members to health, wellness, prevention, and social support programs based on identified needs.
Facilitate referrals to community resources including food assistance, housing support, transportation services, behavioral health resources, financial assistance, employment programs, caregiver support, and wellness initiatives.
Assist individuals in navigating healthcare and community systems to ensure access to appropriate services and resources.
Maintain current knowledge of available community programs, eligibility requirements, and referral processes.
Develop and maintain a comprehensive community resource network and directory.
Build and sustain collaborative relationships with community organizations, healthcare providers, public health agencies, schools, employers, faith-based organizations, and other stakeholders.
Participate in community events, wellness fairs, health screenings, outreach activities, and educational programs.
Represent the organization in community coalitions and collaborative initiatives aimed at improving population health.
Identify opportunities to expand community partnerships and strengthen resource networks.
Promote awareness of available services and programs throughout the community.
Educate individuals and families regarding wellness programs, preventive services, healthy lifestyle behaviors, and available community resources.
Develop chronic disease support initiatives to utilize for patient education.
Promote participation in evidence-based chronic disease prevention and management programs.
Support initiatives focused on nutrition, physical activity, tobacco cessation, mental health, substance use prevention, and overall well-being.
Encourage engagement in preventive healthcare services, screenings, immunizations, and health education opportunities.
Assist individuals in setting personal health and wellness goals.
Facilitate communication among care teams and community organizations to improve continuity of care.
Assist in reducing duplication of services and fragmentation of care delivery.
Conduct screenings and assessments to identify social, economic, environmental, and behavioral barriers impacting health outcomes.
Develop individualized action plans to address identified social needs and wellness goals.
Support interventions that address food insecurity, transportation barriers, housing instability, social isolation, financial hardship, and other social drivers of health.
Collaborate with internal and external partners to improve access to resources that support health and well-being.
Collect and report data related to community navigation activities and program effectiveness.
Participate in quality improvement initiatives aimed at enhancing community-clinical integration and service delivery.
Maintain confidentiality and comply with HIPAA, organizational policies, and applicable regulatory requirements.
Adhere to documentation standards and program guidelines.
Participate in ongoing training and professional development activities.
Support accreditation, the Rural Health Transformation Program, grants, and reporting requirements as applicable.