Clinic Navigator

At Virginia Garcia Memorial Health Center, we welcome diversity; we encourage, uplift, and are honored to serve people who have been historically underrepresented and underserved. Our mission is to provide high-quality, culturally appropriate healthcare to low-income residents of Washington and Yamhill Counties, with a special emphasis on seasonal and migrant farm workers and others with barriers to receiving healthcare. We strive to provide an inclusive environment that welcomes and values the diversity of the people we employ and serve.

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

Job Summary: The Clinic Navigator will function as an integral part of the Primary Care Clinic 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 will link patients to needed community resources through their work on medical and Behavioral Health/Mental Health (BHMH) teams to coordinate services and care that address their medical, mental health, and/or other psychosocial needs of the clinic's patient population. They will utilize specific tools such as Unite Us, SDoH screenings, warm handoffs from PCPs to outreach, engage and address patients' individual needs. The Clinic Navigator will work closely with the BH Department to coordinate care between the BH Clinicians, the Enhanced Care Management Hub, and Substance Use staff within their clinic. They will also work closely with the Outreach Department to coordinate care.

Essential Duties and Responsibilities:

• Functions as an integral part of the primary care medical teams attending huddles, team meetings and coordinating services as assigned by their supervisor.

• Works with the primary care medical teams to assess patient's needs and connect them to resources in the medical and social services community.

• Assesses the patients' social determinants of health and health literacy by 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.

• Gathers and maintains information, resources, and accessible services of community agencies, local and state organizations, acting as a liaison with outside agencies.

• Builds a supportive relationship with patients to improve utilization of necessary and appropriate primary care, mental health, and social services, in order to improve the patients' health status and health outcomes.

• Uses motivational interviewing to assess and positively impact the patient's level of engagement in his or her care and confidence in his or her ability to carry out a self- management plan.

• Communicates with the primary care team, documenting all contacts with patients in the EHR (EPIC) in a timely manner and communicating in person or by phone as needed.

• Provides culturally and clinically appropriate medical, mental health, and substance use education and information to patients, and coaches patients in making healthy lifestyle changes.

• Acts as the patient's advocate and healthcare navigator, assisting them in understanding the most appropriate use of health care resources.

• May facilitate, coordinate, and organize group education or group provider visits, if approved by the supervisor and in consultation with the site management team.

• May supervise students in disciplines appropriate to the Navigator's educational background and qualifications.

• Attends monthly clinical supervisions to consult with BH Manager/Supervisor regarding individual patients and patient care.

• Attends regular trainings as required.

• Ability to travel to clinics, home visits, and agency visits, etc. in a reliable, confidential, and timely manner.

• May be asked to provide remote coverage for other primary care sites based on need.

• Performs other duties as assigned.

• Handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

HIPAA Requirements:

The Navigator will have access to PHI in the course of their duties. They will use PHI to schedule patients, transport patients and coordinate care for patients. Applying the minimum necessary standard of HIPAA the designated record sets to which this employee will have access include: the full medical record, the scheduling and demographic functions of the practice management system.

Knowledge, Skills and Abilities Required:

• Bilingual/bicultural proficiency preferred.

• Desire to work with underserved communities.

• Desire to work with complex patients including those who may be struggling with mental health and/or substance use.

• Cultural competency.

• High level of skill in interpersonal relations and problems solving.

• High energy and self-directed individual with excellent interpersonal, problem solving, organizational and computer skills.

• Ability to take initiative to proactively organize and manage the responsibilities of the job.

• High degree of integrity and professionalism.

• Good working knowledge of available social service resources or skills to acquire knowledge and information expeditiously.

• Ability to work in challenging environments in the community at large and in patients' homes.

• Experience with group facilitation.

• Ability to work as an integral part of a high functioning team.

• Strong user of Microsoft Word and Excel. Prior EMR experience preferred.

• Excellent customer service skills.

• Commitment and alignment to Virginia Garcia's mission, vision, and values.

• Valid Oregon driver's license, reliable transportation, safe driving record and insurance coverage required.

Education and Experience Required:

• Bachelor's degree or at least 4 years of college education, preferably in psychology, social work, human services, or health-related field required, or combined education and experience.

• Meet criteria for QMHA in the state of Oregon; requires a Bachelor's degree in behavioral health or alternatively a combination of three years of relevant education and occupational experience.

• Training in Motivational Interviewing, skills training and case management preferred.

• Current CPR certification.

Behavioral Competencies:

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

Physical Requirements:

Percentage of time spent:

• Standing: 20% up to

• Walking: 25%

• Sitting: 50% up to

• Reaching: 5%

• Must be able to lift/carry up to 20 lbs.: infrequent 20-40 lbs.

• Travel: up to 75%

Working Environment/Physical Hazards

• Work in well-lighted, ventilated office environment.

• Moderate noise in open office with computers, printers and light traffic.

Equipment used:

• Computer

• Telephone, fax, copier, scanner

• Medical equipment

• Glucometer

• Pulse Oximeter
  

Immunization

Staff member must meet immunization requirements as stated in VGMHC's immunization policy and state and federal guidelines.

Job description represent a general outline of the essential and major job duties, functions and qualifications required. They cannot be all-inclusive and comprehensive due to the dynamic nature of work performed to accomplish VGMHC's Mission.

VGMHC is an Equal Opportunity Employer. No person is unlawfully excluded from consideration for employment because of race, color, religious creed, national origin, ancestry, sex, age, veteran status, marital status or physical challenges. The policy applies not only to recruitment and hiring practices, but also includes affirmative action in the area of placement, promotion, transfer, rate of pay and termination.