The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

We are hiring a Patient Health Navigator (TOC) to join our team!

Must reside in California - remote position.

What You Will Be Doing:

Under general supervision, the Patient Health Navigator is responsible for using established protocols to help evaluate members and to help ensure that assigned members understand and can comply with prescribed care plans.

Conducts initial health risk assessments for selected members; triages as appropriate.
Conducts initial and ongoing education of, outreach to and follow-up with members to help ensure they understand and adhere to their care plan.
Assists the member in identifying, completing and/or obtaining the required documents, tests and other items required for medical appointments.
Assists the member in identifying and addressing barriers to their ability to access and keep medical appointments, including arranging for the provision of transportation, DME and translation services.
Collaborates with primary care physicians and HPSJ care management staff to identify members requiring specialty care services.
Refers and connects members to appropriate community resources and support services.
Documents and maintains activities and records in appropriate HPSJ system(s) according to standards.

What You Bring:

Knowledge, Skills, Abilities and Competencies

Required

Produces work that is accurate and complete.
Produces the appropriate amount of work.
Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
Rebounds from setbacks and adversity when facing difficult situations.
Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
Strong knowledge of community healthcare, financial and social resources.
Basic knowledge of medical policy benefits and exclusions.
Basic knowledge of the managed care delivery system.
Basic knowledge of the healthcare issues facing the underserved.
Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
Skills in and ability to use tact and diplomacy to diffuse emotional situations.
Strong communication skills, with the ability to communicate professionally to diverse individuals inside and outside of HPSJ, and effectively explain complex information.
Strong listening skills.
Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
Ability to identify and solve problems in an efficient and effective manner.
Ability to work independently and as part of a team.
Basic analytical skills.
Strong assessment skills.
Basic skills in Word, Excel and Outlook.
Ability to enter data into and navigate through multiple systems.
Ability to speak and be understood in English.
Ability to handle confidential information with appropriate discretion

Preferred

Knowledge of and ability to apply basic medical terminology.
May require proficiency in one of HPSJ’s threshold languages (as defined by HPSJ’s Cultural and Linguistic Program).
Basic knowledge of the principles, practices and regulatory requirements of managed care.
Knowledge of Medi-Cal or other government sponsored programs and regulations as they apply to social work.

What You Have:

Education & Experience

Required

High school diploma or equivalent.
At least two years working as a community health advocate, patient advocate, patient coordinator or similar.

Preferred

Associate’s Degree.
Experience working with Medi-Cal and other government sponsored programs.
Experience working in a managed care setting.

Required

Valid California driver license and reliable transportation, or the ability to obtain transportation on demand in the counties served by HPSJ if prohibited from getting a driver license due to a medically documented disability.

Preferred

Medical Assistant Certification.

HPSJ Perks:

What You Will Get:

Competitive salary
Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
Two flexible spending accounts (FSAs)
Employer-Paid Term Life and AD&D Insurance
Employer-Paid Disability Insurance
Employer-Paid Life Assistance Program
Health Advocacy
Supplemental medical, legal, identity theft protection
Access to exclusive discount mall
Education and training reimbursement in addition to employer-paid elective learning courses.
A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.

We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.

Health Plan of San Joaquin/Mountain Valley Health Plan jobs

Patient Health Navigator (TOC)