Care Navigator

ESSENTIAL JOB FUNCTIONS: Essential functions of the job include, but are not limited to, traveling, driving, utilizing a computer for typing and conducting research, attending meetings, conducting assessments, and counseling.
MAJOR AREAS OF RESPONSIBILITIES:

• Promotes and reinforces patient centered medical home concepts with patients, families, and the Equitas Health care team.
• Participate in the development and implementation of an evidence based, standard screening tool for identifying patient’s social determinants of health. The care navigators will utilize this tool to determine factors that contribute to a patient’s overall health outcomes, and develop the appropriate intervention/care plan for the patient.
• Assist patients in accessing Equitas Health resources and navigating external healthcare and community resources such as housing, respite, nutritional assistance, palliative care, chore assistance, transformation and social functions; taking into consideration reading level, health literacy, culture, and language requirements. Assess barriers to care and engage patients and families in creating potential solutions to overcoming these barriers through the use of motivational interviewing and shared decisions making.
• Refer to community workforce programs and provide supportive services to patients that address the unique barriers to employment individuals may face in returning to work, understanding benefits eligibility, confidentiality and health management in the workplace.
• Collaborates with providers, client services, and care team to develop short and long term strategies in the development of expected patient outcomes as they impact the patient’s physical health, mental health, and ability to function within their day to day environment; collects data through patient tracking to meet patient’s needs.
• Works collaboratively with providers and care team to ensure the delivery of quality of care to patient to ensure the best patient outcome.
• Collects data through patient tracking in order to facilitate patient outcomes data collection and analysis.
• Provide assistance with completing and submitting all necessary documentation related to patient’s care, including documents related to Ryan White benefit, health insurance, medical procedures, and internal and external referral services.
• Serves as a link between Equitas Health Medical Center and Client Services, ensuring patient’s needs are being met with timeliness and efficiency.
• Maintain confidentiality of patients by adhering to Equitas Health Confidentiality Policy and Procedure, HIPAA, and other established professional standards and guidelines.
• Care Navigators are responsible to maintain documentation through Equitas Health, ODH, and other software systems. All documentation will demonstrate best practices and will reflect patient centered and affirming care. All documentation will be recorded and complete within one business days of provided service.
• Effective written and verbal communication skills. Ensure that action items and updates are provided to Supervisor proactively. Capture feedback from patients, families, Equitas Health care team, and community partners and communicate the information to the appropriate persons.
• Returns patient, provider, and other stakeholder correspondence within two business days.
• Responsible for accurate and timely completion of documentation in order to provide accurate data and reports to Equitas Health and its Board, as well as federal, state, and local governments.
• Attend trainings, as assigned, to support professional development and best practices and to maintain standards for licensure.
• Care Navigators will participate in Motivational Interviewing trainings and Learning Groups. As appropriate,…