Community Health Worker-Navigator

Summary:

The Community Health Worker- Navigator is responsible for conducting Health-Related Social Needs (HRSN) Screenings within the Social Care Network (SCN) to identify unmet needs and ensure members are appropriately referred for further support. This role requires accurate data entry in the assigned platform, confirmation of Medicaid eligibility, obtaining informed consent, and proper documentation for Medicaid-billable services. The Community Health Worker- Navigator is often the first point of contact for members and plays a critical role in ensuring timely connection to Navigation Services or Enhanced Care Management.

Essential Duties and Responsibilities

• Accept referrals and initiate screenings after confirming Medicaid status and SCN eligibility.
• Search for members in the designated platform; create or update member profiles as appropriate.
• Verify consent status and obtain new consent if required.
• Review and update member’s demographic information and social care coverage.
• Administer the HRSN Community Health Worker- Navigator, reading questions aloud and documenting responses accurately.
• Manage sensitive questions (e.g., interpersonal violence) with discretion, documenting “declined” or “not asked” responses as appropriate.
• Track and document time spent, participants involved, and any declined screenings.
• Submit completed screenings in designated platform for review.
• Conduct re-screening only when a major life event has occurred (e.g., hospitalization, housing change, incarceration, loss of benefits).
• Document reasons for re-screening, date/time, and duration.
• Submit units for reimbursement per the approved fee schedule.
• Refer members with unmet needs to Navigators or Enhanced Care Management using 

Qualifications

• High School Diploma or equivalent required or Associate’s Degree in Human Services, preferred.
• One (2) year of experience in case management, health care coordination, or community health preferred.
• Bilingual (English/Spanish) strongly preferred.
• Strong organizational, documentation, and data-entry skills with attention to detail.
• Ability to engage with diverse populations professionally and empathetically.