Care Navigator

The Care Navigator is responsible for conducting social care screenings, eligibility assessments, referral coordination, and ongoing care navigation activities for Medicaid members and other eligible populations participating in Social Care Network (SCN), 1115 Waiver, ILOS, Value-Added Benefit (VAB), and related programs. This work is completed telephonically.

The Care Navigator provides person-centered, culturally responsive, trauma-informed telephonic and technology-enabled navigation services designed to identify unmet health-related social needs and connect individuals to appropriate community-based resources and services. Responsibilities include screening completion, eligibility verification, referral placement, closed-loop referral follow-up, documentation, consent management, and coordination with community-based organizations, managed care organizations, and healthcare partners.

Documentation and tracking activities will occur within both internal and external technology platforms. The Care Navigator is expected to maintain compliance with organizational policies, state program requirements, productivity standards, quality metrics, and confidentiality regulations.

The Care Navigator reports to the Care Navigation Program Manager. This is a remote position that may be located anywhere in the United States but CST or EST hours will be worked. Occasional travel to offices in Iowa and New York may be required.

Hourly wage: $23/hour

• Conduct standardized, health-related social needs screenings in accordance with state and program requirements
• Complete eligibility assessments and supporting documentation for social care services and enhanced navigation programs
• Initiate, monitor, and close referrals within designated referral management platforms
• Accurately document and record service activities, encounters, and time spent in accordance with program billing and reporting requirements
• Perform closed-loop referral follow-up activities to confirm service connection and identify unresolved barriers
• Conduct outreach attempts and follow-up activities in accordance with program timelines and documentation standards
• Educate clients regarding available community resources, benefits, and social care services
• Coordinate with healthcare providers, managed care organizations, and community-based organizations to support continuity of care
• Escalate complex cases, urgent social needs, or safety concerns to supervisory or clinical staff as appropriate
• Maintain compliance with HIPAA, confidentiality requirements, and all applicable state and federal regulations
• Meet productivity, timeliness, documentation, and quality assurance standards established by the organization and program requirements
• Participate in ongoing training, workflow updates, and quality improvement initiatives
• Support reassessment and renewal activities as required by program guidelines

 

• Minimum of two (2) years’ experience in a healthcare, social service, or behavioral health setting; this may include any role with direct client contact
• Ability to engage individuals experiencing complex social and health-related barriers with empathy and professionalism
• Ability to maintain accurate and detailed documentation in compliance with regulatory and organizational requirements
• Prior work that included in-person or telephonic interactions with clients or patients
• Excellent written, verbal, and interpersonal communication skills
• Strong organizational skills with the ability to manage multiple priorities simultaneously
• Proficiency with Microsoft Excel and other standard office technology platforms
• Exceptional attention to detail and ability to prioritize competing tasks and projects effectively
• Ability to work independently with minimal supervision while exercising sound professional judgment
• Ability to routinely use standard office equipment and technology, including laptop computers and smartphones

• Training or certification in Trauma-Informed Care, Motivational Interviewing, and/or Crisis De-escalation techniques
• Experience working with individuals experiencing food insecurity, substance use disorders, behavioral health needs, homelessness, and/or transition from incarceration or institutional settings
• Previous experience providing telephonic screenings, care navigation, care management, vocational rehab, or health coaching services