KCOM - Rural Navigator, RHTP

A T Still University of Health • Kirksville, MO

3d • Onsite

About The Position

A.T. Still University's Kirksville College of Osteopathic Medicine is hiring a full-time, exempt Rural Navigator on its Kirksville, Missouri campus. The role serves as a frontline, community-based care coordinator for the four-county Region 16 Hub within Missouri’s Transformation of Rural Community Health Care (ToRCH Care) model, supporting coordination among hospitals, FQHCs, RHCs, behavioral health providers, pharmacies, EMS, local public health agencies, and community-based organizations.

Reporting directly to the Hub Program Director and collaborating closely with the Lead Navigator, the Rural Navigator helps rural residents connect to and complete needed clinical, behavioral, and social services. This non-clinical position conducts screenings, manages referrals, supports resident engagement and follow-through, addresses non-clinical barriers to care, and escalates urgent or complex concerns according to Hub protocols. The position serves residents across Adair, Macon, Knox, and Shelby counties and includes frequent, daily local travel.

The Navigator maintains an active caseload and documents outreach, referrals, and outcomes in approved digital systems. The role also supports community outreach, partner coordination, program outcome reporting, and Hub Board operations. The Navigator does not diagnose, prescribe, or provide licensed clinical treatment.

Requirements

• Four-year college degree in a relevant field is preferred, or equivalent clinical/community care management experience; candidates with nursing credentials such as RN or an associate degree and extensive healthcare navigation experience may also be considered.
• Two to three years of experience required.
• Experience in community outreach, patient navigation, social services, care coordination, public health, or customer service in a healthcare or community-based organization setting.
• Experience conducting resident, client, or patient intake and needs screening and following referrals through to completion.
• Demonstrated experience working directly with rural or high-need populations facing social or economic barriers.
• Experience using digital systems such as CIE, EHR, or case management software for documentation and tracking.
• Knowledge of local community resources, social service systems, and healthcare providers in the assigned multi-county region.
• Basic understanding of social determinants of health, public benefits such as Medicaid, and care coordination concepts.
• Familiarity with data entry, privacy standards including HIPAA, and digital communication tools.
• Ability to collect, organize, and analyze program performance metrics, social determinant data, and healthcare utilization outcomes for reporting and presentation.
• Strong attention to detail and ability to track deadlines and organize projects, clients, and partners.
• Excellent interpersonal, active listening, and relationship-building skills.
• Ability to manage multiple active cases and maintain organized follow-up across residents and partners.
• Strong verbal and written communication skills.
• Practical problem-solving and time-management skills, including the ability to independently manage a field-based caseload.
• Basic computer literacy, including Microsoft Office, Google Workspace, and web-based databases.
• Valid driver’s license and ability to travel within the four-county Hub service area.
• Empathy, compassion, and cultural humility when serving vulnerable populations; adaptability, persistence, integrity, accountability, and respect for client confidentiality.
• Ability to work independently in field environments, follow standardized workflows and documentation requirements, and maintain consistent follow-up.
• Successful completion of required background checks prior to employment.

Nice To Haves

• Certified Community Health Worker (CHW) credential, or experience in Motivational Interviewing, Trauma-Informed Care, or Mental Health First Aid.
• Experience in an FQHC, RHC, Critical Access Hospital, behavioral health agency, local public health agency, EMS, school-based health setting, pharmacy, home visiting program, or related community-based organization.
• Bilingual skills or demonstrated effectiveness serving culturally and geographically diverse rural communities.

Responsibilities

• Conduct standardized intake screenings to identify residents’ clinical, behavioral, and social care needs.
• Initiate and manage closed-loop referrals across Hub partners using the Community Information Exchange (CIE) and other digital systems; escalate emergencies immediately according to Hub policies and protocols.
• Engage Medicaid beneficiaries, dually eligible residents, and high-need individuals through phone calls, field visits, and partner-site follow-ups.
• Assist residents with appointment scheduling, care plan adherence, and service navigation.
• Identify and resolve non-clinical barriers to care, including transportation, benefits or insurance enrollment, medication access, and digital access.
• Lead warm handoffs and support two-way coordination between residents and local partner organizations to maintain continuity of care.
• Maintain an active caseload and track outreach attempts, referral statuses, and outcomes in approved digital systems until services are verified as complete or appropriately transitioned.
• Organize and participate in recurring joint outreach initiatives and local events with Hub partners to build public trust and program awareness.
• Track, aggregate, and report clinical, behavioral, and social care outcomes; assist the Program Director with dashboard metrics, KPIs, and outcome reports for the Rural Health Transformation Office and state partners.
• Support preparation of Hub Board materials, including agendas, metric dashboards, and meeting summaries, as needed.
• Attend Leadership Board meetings to record actions and votes and support follow-up communications, documentation, and proposal preparation.
• Support implementation, workflow execution, and reporting for the state-funded ToRCH Care program in Region 16.
• Deliver community navigation, social care referral management, barrier mitigation, and resident engagement services across Adair, Macon, Knox, and Shelby counties.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Comprehensive benefits package; if eligible, employee-elected benefits begin the first of the month following the hire date.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level