What are the responsibilities and job description for the HEALTH NAVIGATOR position at OPSAM Health?
Job title
HEALTH NAVIGATOR
Reports to
Health Assessment Supervisor
Department : Quality Improvement
Status :
Temporary Assignment 4-6 months (Full Time)
The Organization
Operation Samahan (OpSam Health) is a Federally Qualified Health Center (FQHC) that serves the San Diego County community. Founded in 1973 in a barber shop in Downtown San Diego by Filipino health professionals offering services to immigrants who did not have the finances, linguistic skills, or ability to navigate the health care system. Today, Operation Samahan has evolved into a diverse community health center with services available in National City, Mira Mesa, City Heights, and Rancho Penasquitos. We provide primary care, dental, behavioral health, family planning, integrative health and wellness, healthy eating, civic engagement, and other health related services to the uninsured, underinsured, and underserved families of all income levels regardless of their ability to pay.
JOB PURPOSE
The Health Navigator coordinates with different health plans to ensure compliance issues based on the value of each health plan. Prepares reports on HEDIS measures and communicates the results to the different stakeholders. Visits each clinic to thread with other Patient Care Coordinators as needed. Monitors projects funded by the health plans.
They are responsible for member engagement and bringing members in for health screening to close gaps in care. The goal is to improve member relationships and preventative care outcomes through face-to-face member engagement by the Health Navigator.
ESSENTIAL DUTIES AND RESPONSIBILITIES : Other duties may be assigned
- Comply with department policy and procedures
- Obtain needed data from health plans regarding HEDIS measures
- Collect medical records, conduct reviews and ensure accuracy of documentation for reporting
- Assist in planning and implementation of projects to improve delivery of services and quality of care
- Perform patient outreach and scheduling to close care gaps
- Understand the principles of HEDIS and HIPAA
- Provide in-service training to providers regarding HEDIS and CMS Star Measures
- Generate and maintain accurate reports as required
- Attend to health plan, provider, and interdepartmental calls
- Perform other duties, projects, and actions as assigned
QUALIFICATIONS
Knowledge, Skills, and Abilities :
Education and Experience :
Annual Requirements, Licensure, and Certifications
PHYSICAL DEMANDS
