Social Care Navigator

Job Description

At Virginia Garcia Memorial Health Center, we welcome diversity; we encourage, uplift, and are honored to serve people who have been historically underrepresented and underserved. Our mission is to provide high-quality, culturally appropriate healthcare to low-income residents of Washington and Yamhill Counties, with a special emphasis on seasonal and migrant farm workers and others with barriers to receiving healthcare. We strive to provide an inclusive environment that welcomes and values the diversity of the people we employ and serve.

The Social Care Navigator functions as an integral part of the BHMH Services Department's Primary Care integration to assess and address patient 's needs as related to their resilience/self‑determination, ability to access outpatient services and social determinants of health. This individual provides skills training and case management services and links patients to needed community resources through their work on medical and BHMH teams to coordinate services and care that address their medical, mental health and/or other psychosocial needs.

They also work with the Primary Care Teams to outreach and work with complex health and/or psychosocial needs of patients and those who are high utilizers of hospital and Emergency Department services. This position may supervise students in disciplines appropriate to the Navigator's educational background and qualifications.

• F un c t i on a s a n in te g r a l p a rt of the BHMH Team attending huddles, team meetings and coordinating services with team members for complex patients.
• May work with prim a r y ca r e m e dic a l t ea ms, att e ndi n g huddles a nd te a m me e t i n g s a nd c onn e c t i ng with t ea m m e mbe r s a s n e e d e d to ass e ss patient ' s n ee ds a nd c on n ec t them to r e source s in t he medi ca l and so c i a l s e rvi c e s c om m uni t y .
• B ui l d a supportive re l a t ionship with patients to i mprove p a t i e nts' ut i l iz a t i on of n ece s s a r y a nd a ppro p r i a te p r i m a r y ca r e , m e nt al h ea l t h, a nd s o c ial s e rvi c e s, in ord e r to i m prove the p a t i e nts' h ea l t h st a tus a n d h ea l t h outcom e s.
• Us e mo t ivational in t e rvi e wing to a ssess a nd posi t ive l y affect t he p a t i e nt's lev e l of e ng a g e ment in their ca re a nd c o n fid e n c e in their a bi l i t y to ca r r y o ut a s e l f
  -man a g e ment plan.
• P a rti c ipat e with t he te a m in dev e lop i ng a c omp r e h e nsive c a re p l a n.
• Com m unic a te w i t h the p r i m a r y c a re t e a m, doc u menting a ll c ont a c ts wi th p a t i e nts i n the

E H R ( E P I

C) in a t i me l y mann e r a nd communic a t i ng in p e r son or b y phone a s n ee d e d.

• Prodiv e c ul t ur a l y a nd c l i nic a l l y a ppro p riate me d ic a l and ment a l h e a l t h e d u ca t i on a nd info r mation to patients a nd c o ac h e s p a t i e nts i n m a king h e a l t h y l i f e s t y l e c h a ng e s.
• A c t as the p a t i e nt's a d v o ca te a nd h ea l t h n a v i g a t o r, a ss i s t ing them in unde r standing the most a ppro p ri a te u s e of he a l t h ca re r e s o u r ce s.
• Wo r k with t he P rim a r y C a re T e a ms and BHMH t o outr eac h p a t i e nts with c omp l e x h ea l t h a nd/or p s y c h o s i a l n e e d s a nd those who a r e h i g h ut i l iz e rs of hospital a nd Em e r g e n c y D e p a r tm e nt s e r vi ce s in o rd e r to r e mo v e b a r ri e rs to ca r e .
• Provide work in the community with patients including home or h o spi t a l / ED vis i ts and/or p a t i e nt a cc ompaniments to medi ca l or so c ial s e r v i c e a ppoin t ments.
• M a y f a c i l i t a te, c o ordin a t e a nd o r g a n i z e g roup e d u ca t ion or g roup provid e r vis i ts, i f a ppro ve d b y the supervisor and in c onsultation wi t h the si t e man a g e m e nt t ea m.
• M a y su p e rvise students i n disciplines a ppro p ri a te to t he Navigator's e du c a t i on a l b ac k g round a nd qu a l i fi ca t i ons.
• Atte n d re g ular t r a in i n g s a s r e qu i r e d.
• Per f orm other dut i e s a s a ss i g n e d.
• Handl…