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Summary

The Community Resource Navigator is a certified enrollment specialist to assist community members to get the support they need to access healthcare and health-impacting resources. The Navigator gathers information related to healthcare coverage and economic barriers, healthcare systems concerns, and basic needs (including, but not limited to, food, transportation, and material goods). The Navigator conducts community education regarding opportunities to obtain health care services through affordable public program enrollment and provides application assistance. Conducts timely and thorough follow-up and assists the applicant with identified barriers. The Navigator connects the community with vetted community agencies that address other basic needs. The Navigator also provides support and guidance in accessing health care systems.

Must be able to demonstrate knowledge and skills necessary to perform all job-related activities as outlined below.

Essential Duties and Responsibilities:

Primary Functions:

1. Demonstrates thorough knowledge of available public funded programs including but not limited to Covered California, Medi-Cal, FamilyPACT, EWC, Sliding Fee, Presumptive Eligibility and others as determined appropriate.
2. Conducts presentations at various community sites including at schools, churches, food banks, work sites, WIC offices and other community-based organizations regarding SDAIHC services and healthcare coverage.
3. The Navigator informs the community regarding changes in public programs, new coverage opportunities and retention of coverage. The Navigator will represent SDAIHC at health fairs and community events as assigned.
4. Conducts in-reach and education for uninsured patients or those who have lost coverage.
5. Conducts enrollment and application assistance for public programs. Must thoroughly assess low to moderate income families for qualifications.
6. Promotes program application as an opportunity for healthcare coverage. Demonstrates thorough knowledge of all software programs and practice management system used to perform these responsibilities.
7. The Navigator assists with applications for the sliding fee scale.
8. Accurately completes patient registration when indicated for new patients including demographic information and household assessment according to policies and procedures. Maintains accurate and current information in the practice management system when there are changes in eligibility.
9. Provides assistance and helps families or individuals who face access, utilization/service, or retention (staying in the program) problems. Communicates effectively with program representatives and eligibility workers to identify interventions that assist the applicant in the resolution of limiting barriers to eligibility. Assists applicants to resolve communication barriers regarding eligibility by conducting three-way phone calls, contacting the appropriate agency, and educating the applicant as to the required documentation.
10. Provides extensive follow-up/case management to confirm enrollments to programs, ensure utilization of services and retention of benefits/coverage.
11. Facilitate access to healthcare services by informing the applicants of their benefits and services available to them. Assist patients in understanding preventive health and facilitate coordination of appointments within the organization.
12. Assist families with health plan enrollment or transfer of primary physician.
13. Evaluates patients and applicants for other Social Determinants of Health and assists with connecting the individuals and families with community services that address the identified needs as available.
14. Maintains accurate records of work performed and assistance provided. Submits reports of work completed, on a daily, weekly, and/or monthly basis as requested by management.
15. Other duties as assigned.

Qualifications:

Minimum Qualifications:

1. 18 years of age.
2. Current Certified Enrollment Counselor Certification. California's Health Benefit Exchange - Certified Enrollment Counselors (coveredca.com) - or completion within 30 days of employment - cost reimbursed by SDAIHC
3. High School Diploma or GED equivalent.
4. 1-2 years of experience in the health care or social service industry.

Preferred:

1. Community Health Worker certification preferred.
2. Experience serving a multinational, multicultural population.
3. FQHC background.
4. Familiarity with Community Health Clinics and/or Indian Health Clinics.
5. ECW EHR.
6. Bilingual English/Spanish.

Special Conditions of Employment:

1. Current BLS and CPR certification.
2. Has a clean driving record and insurance as required by the state.
3. Has reliable transportation.

Knowledge, Skills, and Abilities:

1. Excellent oral and written communication skills.
2. Excellent time management skills.
3. Bilingual in Spanish/English.
4. Demonstrated excellent interpersonal communication and presentation skills.
5. Ability to maintain confidentiality and meticulous records.
6. Effective interpersonal skills.
7. Understanding diverse populations demonstrating compassion and understanding.
8. Ability to establish and maintain cooperative working relationships with all during the course of work.
9. Able to perform basic mathematical calculations necessary to perform the job function.
10. Must be reliable and extremely trustworthy.
11. Demonstrated proficiency in Microsoft Suite or related programs.
12. Excellent organizational skills in independently managing workload.
13. Attention to detail required for tracking cases and following up with clients on a timely basis.
14. Have the ability to multi-task and handle multiple cases.
15. Team player – willing to learn, assist and help other team members as required.
16. Demonstrate genuine concern as to the health care and social wellbeing of all people.
17. Ability to use office equipment, i.e. copier, fax.
18. Ability to use the computer, spreadsheet, e-mail, internet and the practice management software and others as trained to utilize.

Physical and Mental Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation.

1. Able to lift/move up to 10 pounds, move from place to place.
2. Able to sit at a desk and work on a computer for prolonged periods.
3. Able to stand, bend and reach for prolonged periods.
4. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress.
5. Ability to supervise, multitask, understand, and follow instructions.
6. Ability to proficiently read, write, speak, and understand English.

Customer Service:

1. Actively supports, promotes, and works to fulfill the Mission, Vision, and core values of SDAIHC.
2. Provides excellent internal and external customer service.
3. Demonstrates SDAIHC’s Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.
4. Participates in on-going customer service training.
5. In every action, seeks to promote SDAIHC as a top service organization.

Quality Management:

Contribute to the success of the organization by participating in quality improvement activities.

Complies with all SDAIHC policies and procedures and proactively participates in the implementation of new initiatives.

Participate and ensures continuous quality improvement process as directed by clinic leadership.

Safety:

Ensures regulatory compliance and adherence with policies and procedures related to safe work practices.

Participate in infection prevention through appropriate use of infection control measures during patient treatment and patient interactions.

Ensure compliance with regulatory requirements for maintaining physical spaces, equipment, and supplies.

Uses all appropriate equipment and/or tools to ensure workplace safety.

Immediately reports unsafe working conditions.

Privacy/Compliance:

Maintains privacy and security of all patients, employee, and volunteer information and access to such information. Such information is accessed on a need-to-know basis for business purposes only.

Complies with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent, or unlawful behavior or activity.

Upholds strict ethical standards.

Flexibility: Available for all shifts and, when required, able to work evenings and weekends

Disclaimer

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. This description reflects managements’ assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.