Social Care Navigator
HybridTroy, New York, United States
Job Summary
Manage incoming referrals for enhanced HRSC services to ensure successful and timely connections are made for each community member. Engage Medicaid members in person, telephonically, or virtually to discuss referrals and work to assist in managing referrals to address health-related social needs using a person-centered, culturally responsive, and trauma-informed approach. Confirm eligibility for services, utilizing Epaces to ensure insurance is active and billable, and conduct HRSN screenings using the Accountable Health Communities tool. Coordinate referrals with individuals and document status to meet health-related social needs, including housing instability, food insecurity, and transportation barriers. Create and oversee social care plans that include a summary of Member needs, eligibility, and services to which they are referred. Ensure referrals are acted upon by HRSN service providers within required timeframes and redirect as necessary to support service connection. Meet billables weekly to ensure viability of program (minimum 5 screenings and assessments daily). Maintain confidentiality and comply with HIPAA, Medicaid, and DOH data privacy and security requirements. Participate in quality assurance, data validation, and utilization monitoring activities related to 1115 Waiver reporting.
Required Qualifications
- Minimum of associate's degree in human services, public health, social work, or related field
- Bachelor's degree preferred
- Experience in case coordination, care navigation, outreach, or direct service provision with Medicaid or underserved populations
- Knowledge of SDOH/HRSN concepts and community-based service systems
- Ability to follow standardized protocols for screening, assessing, referring, documentation, and follow-up
- Demonstrated ability to maintain accurate, timely, and compliant records
- Proficiency with electronic health records and/or DOH-aligned reporting systems
- Strong organizational, communication, and interpersonal skills
- Adherence to DOH guidance, Medicaid regulations, and 1115 Waiver service requirements
- Must have a valid NYS driver's license with a clean MVR
- Ability to be seated and use computer equipment for several hours a day
- Demonstrated ability to thrive in a demanding environment
- Willingness to respond to the needs of a culturally diverse population
- Must be able to lift 50 lbs
Desired Qualifications
- Bachelor's degree preferred
- Experience using translation services
- Preferred experience in supporting individuals with disabilities
- Demonstrated ability to build collaborative working relationships with others inside and outside the organization through cooperation, mutual respect, and capacity to inspire and motivate others
- Thrive working with multiple systems and processes
- Demonstrate the ability to use various technology platforms to ensure successful and timely referral connections are made
- Effectively work in a hybrid work environment
- Demonstrate commitment to the values of diversity, equity, and inclusion
- Extremely detail-oriented and capable of multitasking
- Proficient computer skills and willingness to learn additional software applications
- Ability to thrive in a demanding environment
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