Social Care Navigator

Overview

Social Care Navigator role with responsibilities in resilience/self-determination, access to outpatient services, and social determinants of health. Works with Primary Care teams to coordinate services and develop comprehensive care plans for patients, including mental health and psychosocial needs. Position may supervise students in disciplines appropriate to the Navigator's educational background and qualifications.

Social Care Navigator

Hourly:
Non-Exempt

Mental and Behavioral Health

Represented

Social Care Supervisor

At Virginia Garcia Memorial Health Center, we honor all members of our community and acknowledge the dignity of each person we serve. Our purpose is to provide high quality, comprehensive primary health care to the communities of Washington and Yamhill counties with a special emphasis on migrant and seasonal farm workers and a view to removing barriers to health care. We strive to provide an environment that welcomes and values the people we employ and serve.

If you are unsure whether you meet all the required qualifications for this role but are interested and passionate about this potential position, we encourage you to apply.

The Social Care Navigator functions as an integral part of the BHMH Services Department's Primary Care integration to assess and address patients' needs as related to their resilience/self-determination, ability to access outpatient services and social determinants of health. This individual provides skills training and case management services and links patients to needed community resources through their work on medical and BHMH teams to coordinate services and care that address their medical, mental health and/or other psychosocial needs.

They also work with the Primary Care Teams to outreach and work with complex health and/or psychosocial needs of patients and those who are high utilizers of hospital and Emergency Department services. This position may supervise students in disciplines appropriate to the Navigator's educational background and qualifications.

• Function as an integral part of the BHMH Team attending huddles, team meetings and coordinating services with team members for complex patients.
• May work with primary care medical teams, attending huddles and team meetings and connecting with team members as needed to assess patient needs and connect them to resources in the medical and social services community.
• Assess patients' social determinants of health and health literacy, utilizing screening tools and questionnaires to assess the patient's living situation, health literacy, safety, cognitive abilities or status, history of or current substance misuse, physical, mental or sexual abuse, intimate partner violence, and mental health needs.
• Gather and maintain information, resources and accessible services of community agencies, local and state organizations, acting as a liaison with outside agencies.
• Build a supportive relationship with patients to improve patients' utilization of necessary and appropriate primary care, mental health, and social services, in order to improve the patients' health status and health outcomes.
• Use motivational interviewing to assess and positively affect the patient’s level of engagement in their care and confidence in their ability to carry out a self-management plan.
• Participate with the team in developing a comprehensive care plan.
• Communicate with the primary care team, documenting all contacts with patients in the EHR in a timely manner.

Note: HIPAA (EPIC) in a timely manner and communicating in person or by phone as needed.

• Bachelor's degree in a relevant field or minimum four years of college education, preferably in psychology, social work, human services or health-related field, or equivalent combination of education and experience.
• Meet criteria for QMHA in the state of Oregon (requires a bachelor's degree in behavioral health or a combination of three years of relevant education and occupational experience).
• Training in Motivational Interviewing, skills training and case management preferred.
• Current CPR certification.
• Experience with group facilitation.
• Prior EMR experience preferred.

• Accountability:
  Role model VG's mission, vision, and shared values
• Customer Focus:
  Listen to the voice of the customer and strive to delight them by exceeding their expectations
• Teamwork:
  If someone needs help, help them
• Initiative:
  Be innovative, apply fresh ideas, and continuously improve how you do your work
• Confidentiality:
  Maintain strict confidentiality and respect the privacy of others
• Ethical:
  Demonstrate integrity, honesty, and stewardship in all encounters at work
• Respect:
  Demonstrate consideration and appreciation for co-workers and patients
• Communication:
  Demonstrate the ability to convey thoughts and ideas as well as understand perspective of others

• Percentage of time…