Patient Navigator

GMHC

1d•Hybrid

About The Position

The Patient Navigator provides home and community-based navigation and engagement support to strengthen adherence and retention in care. This role focuses on outreach, follow-up, appointment accompaniment, health education, and barrier reduction for participants who are out of care or at risk of disengaging. The Patient Navigator documents outreach and service activity in the program’s electronic health records (EHR) and internal chart systems and communicates timely field updates to the care team to support coordinated care.

Requirements

Experience providing linkage to care services and navigation support, ensuring timely access to medical, social, and support services.
Strong written and verbal communication skills to interact professionally with clients, colleagues, and external service providers.
Ability to multitask, prioritize, and complete tasks within varying deadlines in a fast-paced environment.
Proven ability to work both independently and collaboratively within a team, with regular supervision and guidance.
Comfort working in the community and in clients’ homes, including field-based follow-up and outreach.
Commitment to trauma-informed
High School Diploma, G.E.D., or H.S.E. or equivalent required.
Intermediate proficiency in Microsoft Excel, including:
Creating and managing spreadsheets to track outreach activity, appointment follow-up, and service connections.
Using formulas, pivot tables, and data validation to ensure accuracy in documentation.
Organizing outreach and referral data for trend analysis.
Basic Proficiency in Microsoft Office Suite, including:
Outlook (email communication, scheduling, and coordination with clients and partners).
Word (creating documentation, educational materials, and official correspondence).
PowerPoint (preparing presentations for internal and external stakeholders).
Experience with electronic enrollment and data tracking systems, such as:
TREAT (internal database) and the New York State Department of Health (NYSDOH) portal.
Data entry and management to ensure contract deliverables are accurately recorded.
Strong documentation and compliance skills, ensuring:
Accurate and timely entry of service data aligned with contract and funder requirements.
Confidentiality and compliance with HIPAA and data privacy standards.

Nice To Haves

Familiarity with marginalized communities in NYC and the unique healthcare challenges faced by priority populations.
Experience conducting outreach, client engagement, or advocacy work in public health or social services.
Ability to effectively communicate and engage with diverse populations.
Bachelor’s degree in social work, Human Services, or a related field preferred.

Responsibilities

Provide home and community-based participant navigation services to support engagement in medical care, treatment adherence, and retention in care.
Conduct outreach and follow-up for participants who miss medical appointments or are not consistently engaged in care, using phone, text, and field-based strategies as appropriate.
Provide appointment reminders, accompaniment to medical appointments, and navigation support to reduce barriers to care.
Deliver health education, adherence support, and mDOT services as assigned and in alignment with program standards and care team direction.
Facilitate linkage to care and navigation services for clients, assisting with barriers such as lack of health insurance or limited healthcare access.
Support linkage to care and navigation services, addressing barriers such as lack of health insurance, limited healthcare access, transportation challenges, and competing social needs.
Maintain up-to-date knowledge of internal and external resources, including community-based services, and support coordinated linkages across the continuum of care.
Participate in participant assessments and service planning activities as assigned and share field observations that inform care coordination and service planning.
Relay timely field updates to the care team and document outreach and service activity promptly to support continuity of care.
Participate in team meetings, case conferences, and supervision sessions to coordinate participant follow-up plans and strengthen service delivery.
Maintain accurate and timely documentation of participant interactions, outreach attempts, services provided, and referrals in the program’s electronic health records (EHR) and internal chart systems, including TREAT and AWARDS, in accordance with required timeframes.
Ensure documentation supports reporting readiness and program deliverables, including used for funder reporting processes such as eSHARE submissions completed by designated staff.
Ensure compliance with confidentiality regulations, including HIPAA and Article 27-F of the NYS Public Health Law, by securely handling and storing sensitive client information.
Participate in trainings and professional development opportunities, as directed by the supervisor, to enhance skills and knowledge in client navigation, sexual health, harm reduction and engagement strategies.
Assist with special projects and initiatives as assigned by supervisor.
Perform other duties as assigned.