Patient Navigator

SUMMARY:

The Patient Navigator – Healthcare Marketplace is responsible for assisting patients and community members in understanding and accessing health coverage through the Healthcare Marketplace (Affordable Care Act). This position provides one-on-one support, education, and outreach to ensure individuals are enrolled in appropriate health plans and are able to maintain continuous coverage. The Patient Navigator plays a critical role in reducing barriers to care and improving overall health outcomes.

This position is partially funded through a grant from the Integrated Network (IHN), specifically, 50% of the annual salary allocation is supported by this grant. Position continuance is contingent upon continued grant contract awards.

DUTIES AND RESPONSIBILITIES:

• Provide individualized assistance to patients and community members regarding health insurance options through the Healthcare Marketplace.
• Guide individuals through the application and enrollment process for coverage, including Medicaid, CHIP, and Marketplace plans.
• Educate patients about eligibility criteria, plan benefits, and the implications of different coverage options.
• Maintain accurate, up-to-date knowledge of federal and state health coverage regulations, including open enrollment timelines, special enrollment periods, and subsidies.
• Coordinate with internal departments (e.g., registration, billing, and care management) to support continuity of care and minimize disruptions in coverage.
• Conduct outreach events, presentations, and education sessions in the community to promote awareness of Marketplace options.
• Maintain confidentiality and ensure compliance with HIPAA and all applicable laws and regulations.
• Track and document patient interactions, outcomes, and referrals in designated systems or databases.
• Participate in ongoing training and certification as required by federal and state regulations.

QUALIFICATIONS:

Education and Experience:

• High school diploma or GED required; Associate’s or Bachelor’s degree in social work, healthcare administration, public health, or related field preferred.
• 1–2 years of experience in healthcare navigation, insurance enrollment, case management, or a related area.

Certifications/Licenses Required:

• Navigator – Active Insurance License required.

Additional Requirements:

• Proficient in Microsoft Office and enrollment systems (e.g., CMS Marketplace tools, state Medicaid portals)
• The ability to travel and float between multiple sites to support patient navigation and outreach efforts.
• Valid driver’s license
• Proof of insurance

COMPETENCIES:

• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
• Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
• approaches and ideas; Presents ideas and information in a manner that gets others' attention.
• Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Motivation - Sets and achieves challenging goals; Demonstrates persistence and overcomes obstacles; Measures self against standard of excellence; Takes calculated risks to accomplish goals.
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
• Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values; Benefits organization through outside activities; Supports affirmative action and respects diversity.
• Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
• Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
• Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
• Safety and Security - Observes safety and security procedures; Determines appropriate action beyond guidelines; Reports potentially unsafe conditions; Uses equipment and materials properly.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
• Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Must be able to sit, stand, and walk for extended periods of time.
• Occasional lifting of materials and supplies up to 25 pounds may be required.
• Ability to bend, stoop, reach, and perform repetitive hand motions.
• May be required to assist with setting up outreach events, including transporting informational materials and display items.
• The noise level in the work environment is usually moderate, typical of an office setting.

This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification. Employees may be required to perform other job-related functions as necessary based on operational needs.