Community Care Navigator (Part-time: 25 hours per week)

Job Description

Job Description

Description:

Position Summary:

• Deliver telephonic and electronic support services to individuals managing chronic health conditions and caregivers of older adults, providing guidance, coordination, and resource navigation.
• Manage a caseload of assigned individuals; support outreach and engagement efforts to promote service awareness and participation.

Essential Duties and Responsibilities:

The following description is a general representation of the key duties and responsibilities of the position. 

Service Delivery & Client Support

• Provide high-touch, person-centered care planning and consultation services via telephone and computer in alignment with evidence-based protocols and applicable federal regulations (e.g., GUIDE).
• Develop personalized care strategies, including respite plans, including for clients without caregivers or those who live alone.
• Support clients and caregivers by identifying challenges related to chronic conditions and dementia and connecting them with appropriate community-based resources.

Communication & Collaboration

• Maintain ongoing communication and collaboration with referral partners to coordinate care and ensure timely sharing of information between platforms (e.g., Action Plans uploaded to EMRs; health system notes integrated into client records).
• Establish and maintain effective working relationships with colleagues, leadership, and community stakeholders to support integrated service delivery.

Documentation & Compliance

• Complete accurate, high-quality documentation in designated client record and billing systems (e.g., CCIS, BenRose360) in a timely manner.
• Ensure compliance with all applicable laws, regulations, and ethical standards related to confidentiality, protected health information, and adult mistreatment.
• Maintain current knowledge of community services, referral protocols, and eligibility guidelines within the geographic regions served.

Training & Professional Development

• Complete all required onboarding and ongoing training to ensure service proficiency and compliance with federal program requirements (including GUIDE).
• Maintain applicable licensure and certifications; participate in continuing education to support ongoing professional development and service excellence.

Other Functions and Responsibilities

• Work independently on most clinical and administrative matters while seeking supervision or consultation as needed.
• Participate in internal committees, projects, or other initiatives as assigned.
• Contribute to outreach and awareness efforts to promote the organization’s services and mission to potential partners and stakeholders.
• May perform limited case management functions, including outreach calls and assistance with required forms or documentation.

Specific knowledge, training or skills required to perform the duties of this position including specific courses, training programs or required certifications. The requirements listed below are representative of the knowledge, skills and abilities required for the position. 

• Bachelor’s degree in social work, nursing, or a related field in aging services.
• Current and unrestricted Ohio licensure (e.g., LSW) preferred.
• Strong verbal, written, and electronic communication skills.
• Demonstrated ability to work independently, prioritize tasks, and manage time effectively.
• Proficiency in Microsoft Office and ability to learn and navigate client documentation systems.
• Understanding of the needs and challenges faced by individuals with chronic conditions and dementia, and their caregivers.
• Knowledge of relevant laws, ethical standards, and confidentiality requirements.
• Sensitivity to cultural and age-related diversity.
• Comfortable delivering services and documentation entirely via telephone and computer.

Previous Experience that is necessary to qualify for this position:

• Minimum three (3) years of experience working with individuals with chronic health conditions (preferably older adults) and their family/friend caregivers.
• Prior experience working in the healthcare setting

Essential Physical Demands and Working Environment

(The physical demands and work environment described below are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions.)

This job operates in a professional office or home office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

• While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, keyboard and telephone.
• Specific vision abilities required by this job include close vision requirements due to computer work.
• Able to work remotely if necessary.
• Able to perform general office activities.
• Light lifting is required, up to 15 pounds occasionally.
• Some flexibility with work hours. 
• Moderate noise (i.e. business office with computers, phone, and printers, light traffic).
• Ability to sit at a computer terminal for an extended period of time.
• Work environment is stressful at times.

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions. Other functions may be assigned, and management retains the right to add or change the duties at any time.