The Patient Navigator will be responsible for providing client centered support and education to patients. Through a collaborative effort with the patient’s care team, the Patient Navigator will coordinate and advocate for services that will promote positive health outcomes. Conduct outreach and educational efforts to patients related to the program area where assigned. Conduct outreach to patients who are eligible for Part A MCM, have become lost to contact and make follow up phone calls to patients who miss appointments, if they are receptive to the calls. Insure that program goals of patient outcomes are documented in AIRS/eSHARE so that annual service units can be met and demonstrates ability to set priorities and manage time in an efficient manner. Responsible to document all intervention conducted with the patient or on their behalf in AIRS and or eSHARE in a manner that is timely, accurate and error free. Track all interventions on the program specific patient contact log. Documentation is to be completed immediately following the intervention and program specific monthly monitoring data is to be submitted to Assistant Clinical Supervisor by the 8th of the following month. Ensure that patient confidential health care and personal information is protected at all time. Responsible to ensure that appropriate consent forms are signed and updated as required. Ensure that exchanges of information are only disclosed to those individuals for which patient consent has been obtained. Responsible for the safeguarding of electronic devices and passwords. Work as a team player in all areas to enhance the program as a whole. Hear staff and patient concerns in an open and solution oriented manner. Provide effective customer service as well as culturally and linguistically appropriate care to all customers (internal and external). Responsible to actively participate in the Department’s Quality Improvement and Quality Assurance efforts as directed by supervisor, including but not limited to participation on the Department’s Quality Improvement Committee. Independently travel to patient’s home and any other site to accompany patient’s to specialty care appointments, if needed. Other job duties as requested by supervisor. Responsible to locate and engage patients who may meet the eligibility criteria for program enrollment. (This includes identifying those who are reported by their medical providers, the program’s organizations or organizations with which the program has linkage agreements as virally unsuppressed, lost to care or newly diagnosed). Follow up assessment to reevaluate & record patient eligibility, engagement in care and services, emerging health and service needs, progress towards achieving service plan goals, substance use, mental health, and risk behaviors. Evaluation of patient’s self-management skills. (Assessment may include evaluation of patient knowledge about HIV, treatment, make, keep and track appointments, manage prescriptions, adherence to treatment, access healthcare and maintain coverage for healthcare services). Administrative activities and tasks associated with helping patient gain access to health care, supportive services, housing, entitlements, benefits and other needed services, i.e. completion of forms and other necessary paperwork and other administrative tasks to connect client to needed services. Remind patient of upcoming appointments for services provided the program. (Includes both phone call, text (Valera App) and face-to-face reminders). Locate patients who without providing prior notification have missed an appointment for health or supportive services. (Via phone calls, letters, text messages, emails or in-person visits to the client’s residence or other locations the client is known to frequent). Verification that a patient has kept a scheduled appointment with a provider of supportive services or followed through on a referral to a provider of supportive services. (e.g., harm reduction services, services that address patient’s basic needs such as food, shelter, and hygiene products, employment, legal, psychoeducation, counseling and substance abuse counseling). Escorting and/or accompanying patient to health and supportive service appointments. One-on-one educational session covering one or more health promotion topics in response to client’s needs and interests. (E.g. HIV biology, care management, communication w/providers, substance use, behavioral health, social support, harm reduction, wellness, adherence to care and treatment). Conduct home visits to assess patient medication management strategies and to address barriers to adherence.
High School diploma or GED minimum, Associates Degree in Human Services or Social Work (preferred). Completion of NYS-Department of Health’s Peer Education Training or either case management certification by CUCS or at least 90 hours of documented training equivalent to those required by the NYS Peer Worker Certification program. Applicant must have at least 12 months experience in patient navigator or similar work. Some education/experience/personal knowledge relating to HIV. Possesses well-developed and effective interpersonal skills and is able to communicate effectively verbally and in writing. Demonstrates confidence in actions and exercises good judgment. Possesses the ability to plan, organize, develop and implement goals, objectives, policies and procedures necessary for quality care. Demonstrates ability to recognize problems, approach them in an objective manner and work collaboratively toward solutions is essential. Valid drivers license required. Access to personal car for work related travel required. Bilingual Spanish/English required.
The Patient Navigator will be responsible for providing client centered support and education to patients. Through a collaborative effort with the patient’s care team, the Patient Navigator will coordinate and…