AccessHealth Program Navigator, Community and Social Health (Full-time, Day)
About The Position
The AccessHealth Program Navigator, Community and Social Health (Full-time, Day) role involves identifying and enrolling eligible patients into the Access Health program, providing healthcare navigation services, coordinating medical home placements and first appointments, and collaborating with a multi-disciplinary team to address social determinants of health. The navigator will arrange supportive services and referrals to other Accountable Communities resources to improve health outcomes and prevent avoidable hospital admissions or emergency department visits. Responsibilities may include limited health coaching and advocacy to improve appropriate healthcare utilization, and assistance with applications for hospital sponsorship, prescription assistance, and other benefit programs. The role requires managing an assigned caseload with a minimum quarterly contact with patients, participating in community outreach events, and supporting leadership with data requests for reporting to funders and State agencies.
Requirements
- High school diploma or GED.
- Five (5) years of care coordination, non-profit, community health or related experience.
- Knowledge of office equipment.
- Computer skills (word processing, spreadsheets, database, data entry).
Nice To Haves
- Bachelor's degree in a related field of study with one (1) year of care coordination, nonprofit, community health or related experience preferred.
- Associate degree in a related field of study with three (3) years of care coordination, nonprofit, community health or related experience.
- Experience with or in medical settings.
- Bilingual (English and Spanish).
Responsibilities
- Identifies and enrolls eligible patients into the Access Health (AH) program.
- Provides healthcare navigation services to enrolled AH patients.
- Coordinates medical home placements and first appointments.
- Collaborates with a multi-disciplinary team to address the social determinants of health.
- Arranges supportive services and referrals to other Accountable Communities resources.
- Provides limited health coaching and advocacy to improve AH patients' appropriate healthcare utilization.
- Assists patients with applications for hospital sponsorship, prescription assistance, and/or other benefit programs.
- Maintains a caseload of patients with whom they communicate at least once per quarter or more depending upon need.
- Completes regular care plan reviews and updates as necessary.
- Serves as the liaison between participants, Prisma Health departments/services, medical homes, and other providers.
- Assists in developing and maintaining a network of human services and community resources that partner with Access Health.
- Works with team(s) to collect and report outcomes, referrals, and other relevant data to partners and funders.
- Performs other duties as assigned and to meet the goals of the program.
- Receives referrals and enrolls eligible patients from the Emergency Department, inpatient, clinic, and/or other settings.
- Confirms eligibility and re-enrolls eligible patients every year.
- Completes assessments and creates care plans to assist with identified needs including medical home placement and prescription assistance.
- Makes referrals to Community Health Workers, Social Workers, and other Accountable Community resources as indicated.
- Monitors patient activity in the system to support appropriate utilization of services.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
