Patient Care Navigator

Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Harbor Health also operates two Programs for All-Inclusive Care for the Elderly in Mattapan and Brockton, providing comprehensive healthcare, transportation and social services for more than 580 frail elders and a Woman, Infants and Children (WIC) Nutrition Program. To help further the mission of Harbor, we are looking for a talented Patient Care Navigator  to join our Care Team at the Daniel Driscoll-Neponset Health Center in Dorchester. 

We offer an excellent, comprehensive benefits package including Health, Dental, Vision, Life, & Disability insurance, 403b Savings Plan, Generous Paid Time Off plus 11 additional Holidays and much more! 

Role: 

The Patient Care Navigator (PCN) works with the patient’s primary care and behavioral health team to address the complex non-medical needs that can negatively affect a person’s health and well-being. The PCN promotes patient-centered comprehensive and coordinated care supporting the patient and their family in navigating medical, social services and legal systems. 

Responsibilities: 

• Establishes trusting relationships with patients and their families.
• Establishes good working relationships with patients’ primary care teams, the Behavioral Health team, MAT team, Client Services, Financial Counselors, Interpretive services, front desk staff, Referrals Department, Call Center, the WIC program, Food Pantry staff, and other clinical specialists so that all team members are empowered to refer to the PCN.
• Connects patients with concrete community resources, including food resources, subsidized childcare, housing, legal services, financial assistance, IEP’s with school systems and immigration services.
• Actively listens to patients/clients, analyzes needs and concerns and applies knowledge of health center and community resources to assist in resolving issues. 
• Provides direct assistance to patients with completing paperwork to access resources and benefits when literacy, language or comprehension is a barrier.
• Assists patients with completing applications and registration forms.
• Assists patients with navigating services of third-party agencies, such as Inspectional Services, Massachusetts Commission for the Blind and Deaf/Hard of Hearing, MassHealth, Personal Care Attendant Services, Senior Services, Fuel Assistance, Low Income Housing applications, SNAP benefits, Transportation Services and homeless shelters.
• Assists patients with complex medical needs coordinate appointments, assists with scheduling transportation, and with any other barriers for patients getting to their appointments, including assisting with appointment reminders.
• Connects patients to and assists with accessing Social Security Disability and Department of Transitional assistance benefits, including support with the application process, interview preparation, completing needed paperwork and follow up. 
• Actively participates in complex care team meetings, MAT team meetings, and care conferences at the Behavioral Health department meetings, and other team meetings as assigned.
• Coordinates services to ensure quality standards are met for BACO.
• Documents and manages clear care plans, goals and referrals in EPIC. 
• Maintains updated information on contacts with community partners/agencies.

Requirements: 

• Bachelor’s degree in Social Work, Psychology, Human Services or related field
•  2 years of experience working in a community-based setting preferred
• Current BLS (Basic Life Support for Healthcare Providers) Certification required
• Written and oral fluency in English required, fluency in Vietnamese or Spanish and English desired 
• Experience working in a multi-cultural setting
• Microsoft Office 365 proficiency including Word, Excel and Outlook and Teams
• Ability to initiate and maintain positive working relationships with Harbor staff and staff at other organizations
• Knowledgeable with the local community resources.
• Excellent communication skills.
• Duties requires travel between Health Centers and to other consortium clinics as needed; must be able to travel in a timely manner to other HHSI site and other outside agencies as needed  

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.