Patient Care Navigator II, Enhanced Care Management (ECM)
About The Position
The Patient Care Navigator II is a role that blends care coordination responsibilities with community engagement. This role supports the Cal AIM Enhanced Care Management (ECM) program and maintains an assigned caseload. Patient Care Navigator II provides care coordination, connection to medical, behavioral health, and social services, and ongoing engagement to support members' needs. The Patient Care Navigator II works closely with RN Care Managers (RNCM), Licensed Vocational Nurses (LVNs), Behavioral Health Care Managers (BHCM), Community Health Workers (CHWs), Health providers, and community partners to ensure appropriate access to care.
Requirements
- High school diploma or equivalent required; Associate's or bachelor's degree in health administration, Public Health, Social Work, Sociology, Psychology, or related field preferred
- Experience in care coordination, community health work, case management, or social services
- Experience working with high-risk or vulnerable populations
- Strong interpersonal, organizational, and communication skills
- Ability to manage a caseload and prioritize multiple tasks in a fast-paced environment
- Comfortable with field-based, community, and home visits
- Proficiency with electronic health records and care management platforms
- Reliable transportation with active insurance coverage
Nice To Haves
- Experience working within CalAIM, ECM, managed care, or Medicaid programs
- Knowledge of community-based resources and social service systems
- Bilingual abilities preferred
Responsibilities
- Maintain an assigned caseload of ECM Members in accordance with Medi-Cal guidelines
- Provide ongoing outreach, engagement, and follow-up with members via phone and in-person visits, based on assigned tier level and member need
- Conduct face-to-face visits as required by member risk tier
- Provide care coordination support, including appointment scheduling, transportation arrangements, referral tracking, and follow-up
- Ensure smooth transitions of care, including coordination with hospitals and facilities related to admissions and discharges
- Utilize motivational interviewing to engage members in care
- Connect members to community resources and social services, including housing, food, transportation, and other identified needs
- Promote member self-efficacy and shared decision-making in care planning
- Collaborate with RNCMs, LVNs, BHCMs, CHWs, and other care team members regarding members' care needs
- Support care team members with delegated clerical tasks as appropriate
- Assign members to appropriate Case Managers based on risk category and available clinical data
- Track and ensure completion of required assessments and screenings, including Health Assessments and Shared Care Plans
- Maintain timely, accurate documentation in the ECM care management platform in compliance with program requirements
- Attend meetings with providers, health plans, community partners, and internal stakeholders
- Complete additional tasks and projects assigned to support ECM program goals
Benefits
- As a firm passionate about health care, we're deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/why-cope-health-solutions/
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
