Navigator

Title: Patient Centered Medical Home Navigator

Reports to: Health Center Administrator

FLSA Status: Non-Exempt

Personnel Supervised: None

POSITION SUMMARY:

The Patient-Centered Medical Home Navigator is responsible for assisting clients in the application of various public assistance programs and social needs. They include the following: Case management, benefit counseling or eligibility assistance, health education and supportive counseling, interpretation, outreach, transportation, and education of patients and the community regarding the services offered by Central Florida Health Care.

MINIMAL QUALIFICATIONS:

• Education: Associate degree with the major focus being a medical or social work environment or High School Diploma and equivalent experience.
• Experience: One year of experience where the major responsibility was in any one of the following categories - public health, community health center, economic services, counseling, Community Health Worker, medical billing/collections, and/or processing insurance claims.
• Ability to work collaboratively in a team healthcare environment.
• Bilingual: English/Spanish/Creole or French Preferred
• Preferred Certifications: CHW, CAC
  
  
  

SKILLS:

• Must be able to assist in the application of various public assistance and internal CFHC programs, entering very sensitive information into a variety of computer systems in a fast-paced environment.
• Expected to assist patients in navigating the healthcare system by scheduling appointments and providing education on Health Care Insurance alternatives.
• Ability to work independently, problem-solving, and critical-thinking skills
• Must be able to prioritize work, handle high patient volume, and be flexible with your schedule and outreach events.
• Must be able to support patients who need assistance with iPad or smartphone.
• Must abide by the policies, procedures, laws, rules, and regulations of Central Florida
  
  
  

Health Care, Inc., the Department of Children and Families, Florida Healthy Kids Corporation (Kid Care), Federal Exchange marketplace, SFS, Polk Health Plan and any other social program for which an application is made.

• Must be prepared to report suspected child or elderly abuse as well as suspected fraud or Domestic Violence to the appropriate authorities.
• Develop relationships with local agencies and community resources in your service area, to enhance available resources for patients.
• Must be computer literate.
• Must be culturally sensitive to language, and other types of diversity.
  
  
  

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:

• Ensure participate in the PCMH Navigator training, meetings, and quality improvement initiatives related to PCMH standards.
• Ensure that all Patient Centered Medical Home Navigator items are in place, (i.e., posters, as well as adequate brochures).
• Ensure all annual Required/Optional training for Certified Application Counselors is completed.
• Provide service to a minimum of 12-15 customers per day. Provide the required monthly assist and encounter patient numbers every month.
• Conduct face-to-face case management visits that evaluate, assess, and plan for clients’ social welfare needs that may otherwise be a hindrance to optimum delivery of health care. This will be documented on the patient progress note which will have an assessment and associated current procedural terminology.
• Coordinate with the Health Care team to ensure uninsured patients complete Health Insurance applications.
• Liaison with providers and/or agencies providing economic services and other required services in order to establish economic services eligibility.
• Travel to other CFHC sites, meetings, training, and other CFHC activities when required.
• Assist/verify the client’s application process for Florida’s Children’s Health Insurance Programs (CHIP) which consist of the following: Medicaid, FL Healthy Kids, Medi Kids, and Children’s Medical Services (CMS). In addition, the Polk Health Care Plan, Marketplace Health Exchange applications, and all Sliding Fee Scale programs are offered.
• Assist with enrollment, understanding the difference between health plans, and how to use the benefits offered by the Insurance plan.
• Monitor client application process and appointment compliance renewal, complying with required accurate documentation needed to assess applications/or Social Security eligibility, when appropriate. This includes completing all the required paperwork with the client.
• Assist the client with applications for Child Support Enforcement and Unemployment when required.
• Create and maintain a database on your application Partner Access website of client applications, monitoring approvals/denials daily.
• Refer patients with PEPW qualifications to approval applicant staff. Patient data needs to be documented into the State of Florida’s PEPW system. (OB only)
• Apply for insurance/Medicaid authorizations for OB/GYN surgeries. (OB only)
• Conduct on-going contact, over the phone or face-to-face services when necessary.
• Act as an advocate for the client and/or caregiver.
• Receive and assist referrals/walk-ins and attempt to contact no-show patients no less than three times to engage the client in receiving services. Document the tried-to contact in the patient chart.
• Provide referrals to appropriate departments, agencies and community programs as necessary for case management under PCMH.
• Availability and choice of appointment times should attempt to accommodate the client’s schedule and needs.
• Attend all center staff meetings, PCMH Navigator quarterly and monthly TEAMS meetings, and or assigned meetings, as appropriate.
• Attend Health Fairs, and other community events and perform health education as required.
• Work with All Central Florida Health Care, Inc. staff to ensure continuity of care is maintained and address needs that are barriers to care.
• Other duties as assigned
  
  
  

PHYSICAL REQUIREMENTS:

• Requires 80% or more time spent standing/sitting.
• Independently mobile
• Lifting and/or transporting up to 20 pounds.
  
  
  

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.