Description

Summary of Position: The Health Navigator is designed to work directly with and on behalf of indigent, homeless, and uninsured patients who present frequently, and often for inappropriate healthcare needs, at local Emergency Departments with whom Circle the City has formal partnerships. The goal of the Health Navigator is to end the inappropriate overuse of emergency rooms and inpatient hospitalization by chronically homeless individuals who are medically-vulnerable and to assist them with their benefits, identification of a medical home at Circle the City and to work collaboratively with community partners for shelter, benefits, and housing assessment and placement. The Health Navigator is co-located within partner Emergency Departments and works with hospital clinical and social work staff to identify, screen, and refer these high-utilizing patients to more appropriate and less costly medical settings at CTC.

This position will be located at John C. Lincoln- 2nd Street and Dunlap 

Key Functions and Responsibilities:

• Outreach and Consumer Identification: Engage chronically homeless, medically needy adults who are frequent users of hospital and emergency services annually.
• Assessment and Planning: Will develop an individualized plan to move these individuals from an emergency care model to a preventative primary care model.
• Direct Service Provision and Intervention to include:
  • Initiate transition of care into Circle the City's Respite Centers
  • Ensure all referral medical records are uploaded into NaviHealth and available for our Respite Intake Team
  • Communicate status of the referral to your Case Management Team and report progress
  • Ensure patients have their medication lists upon discharge
  • Arrange transportation from the hospital to our Respite Center.
  • Work directly with shelter services to ensure the patient has a coordinated entry into shelter services and a reserved bed waiting for them upon discharge. 
  • Assist patients in scheduling post discharge appointments and ensure any barriers to care are addressed prior to discharge.
  • Address the patient/resident as a whole, including all social factors related to chronic health issues.
  • Move homeless individuals into respite care and stable permanent housing.
  • Plan for health assessment and identification of health needs/plan of action. Establish primary care provider, targeted Health Education, maintain AHCCCS/health care enrollment.
  • Access and coordinate inpatient and outpatient mental health/substance use treatment services as needed.
• Plan for achieving financial stability, education and/or workforce development. Coordinate referrals to community partners to complete applications for all entitlement benefits eligible for, and transition to appropriate education or training employment. Monitoring, evaluation and follow-up, advocacy and collaboration include:
  • Participate in multi-disciplinary team meetings as needed to coordinate patient services and review accomplishments.
• Other duties as assigned

Qualifications

Education:

• Master’s Degree in behavioral health field
• OR Bachelor’s Degree in behavioral health field with 2 years’ experience
• OR Associates of Arts Degree in behavioral health field and 4 years’ experience (Behavioral Health Technician)
• OR 4 years’ experience in a medical environment, clinic or physician setting

Work Experience/Skills Requirement:

• Strong interpersonal skills with an ability to work effectively with a wide range of people, teams, managers, supervisors, and vendors.
• Demonstrate excellent written and oral communication skills.
• Excellent customer service skills.
• Experience in working with the culturally diverse, chronically homeless and medically needy individuals preferred
• Must demonstrate critical thinking, problem-solving and organizational and time management skills.
• Must be able to work well with others in a team approach.
• Possess and maintain a valid Arizona driver’s license.
• MS Office proficiency.
• Bilingual-Spanish desired.
• Knowledge of economic, educational and social problems of individuals experiencing homelessness and referral sources available preferred.
• Must have working knowledge of care management, community resources and resource/utilization management.

Physical and Mental Requirements

• Demonstrated interest in working with an underserved population.
• Position requires extended periods of sitting and standing.
• Position requires regular bending and reaching, including transfer of patients.
• Must be able to lift, carry and push 50 pounds on a regular basis.

We are an equal-opportunity employer. All resumes will be reviewed for education and experience. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.