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Job Information
North Shore Community Health Patient Access Navigator (Full Time) in Gloucester, Massachusetts
Patient Access Navigator (Full Time)
Gloucester, MA (http://maps.google.com/maps?q=302+Washington+Street+Gloucester+MA+USA+01930)
Description
THE ORGANIZATION
North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the surrounding communities with comprehensive and culturally sensitive care. With a strong commitment to excellence, NSCH provides:
Comprehensive primary care.
Dental services.
Behavioral health care.
Care management.
Pharmacy services.
Substance abuse disorder treatment.
Nurse care management.
Insurance enrollment assistance.
NSCH operates service sites at Gloucester, Peabody, and Salem Family Health Centers, ensuring convenient access to care. Additionally, NSCH extends its reach through school-based health centers within the Salem and Peabody School Districts. NSCH collaborates with Bentley Academy, Collins Middle School, Horace Mann School, Bates Elementary School, and the Peabody Learning Academy for behavioral health services.
As a community-based safety net healthcare provider, NSCH actively encourages diversity and welcomes staff members who reflect the rich tapestry of our communities. We highly value the contributions of our team members and offer a wide range of perks and comprehensive benefits. These include health and wellness benefits, tuition reimbursement, loan forgiveness opportunities, and other appealing benefits.
We believe in supporting our employees from day one, and all eligible staff members can take advantage of these benefits right from the start of their employment at NSCH. We aim to foster a supportive and rewarding environment that empowers our team members to provide exceptional care to our communities.
Primary Purpose of Position:
North Shore Community Health (NSCH) is an industry leader in exceptional delivery of community healthcare. We are seeking a dedicated and detail-oriented Patient Access Navigator to join our team at North Shore Community Health (NSCH). The primary purpose of this role is to assist patients with navigating the financial complexities related to paying for healthcare. The Patient Access Navigator would be responsible for ensuring community members can effectively enroll, re-enroll, or manage their insurance coverage or otherwise cover the cost of their health care services. This includes providing support for plan changes, managing essential personal documents, and offering internal financial assistance through sliding fee scales and payment plans.
In addition to individual patient support, the Patient Access Navigator will also engage in outreach efforts to boost MassHealth C3 enrollment, build relationships with community organizations, and organize educational events. The successful candidate will maintain high-quality customer service, track personal metrics, and collaborate closely with other NSCH Navigators, all while ensuring compliance with state and federal guidelines and maintaining certification as a Certified Application Counselor (CAC).
Essential Functions:
· Provide navigational services for MassHealth and ConnectorCare plans, assisting NSCH patients with enrollment, re-enrollment, and insurance management to ensure effective care delivery.
· Act as a delegate for clients when necessary to overcome barriers to MassHealth or ConnectorCare enrollment.
· Assist patients with North Shore's internal financial assistance programs, including sliding fee scales and payment plans.
· Manage work queues and in-baskets within NSCH’s EHR to identify referrals to Patient Access Navigator services.
· Work in a flexible environment to balance pre-scheduled appointments, walk-ins, and ad-hoc needs, ensuring high-quality customer service for NSCH patients.
· Establish and maintain relationships with community organizations, organizing educational and enrollment events.
· Attend occasional evening and weekend community events, such as health fairs and festivals, to educate and enroll consumers in insurance programs on-site.
· Manage personal documents required for insurance enrollment professionally and in compliance with policies, even in non-traditional settings.
· Utilize information from NSCH's EHR and MassHealth to identify and resolve eligibility and coverage issues, maintaining continuity of care for patients.
· Performs outreach aimed at boosting MassHealth C3 enrollment, including engaging uninsured and underinsured patients, scheduling newly enrolled patients assigned to North Shore, and navigating changes to non-C3 ACO MassHealth patients seeking routine care at an NSCH health center.
· Ensure that patients participating in plans with which North Shore maintains a value-based agreement are able to fully benefit from Value-Based care, are properly enrolled and engaged in care.
· Fax and upload documents to the MassHealth portal as provided by patients.
· Track personal metrics related to outreach, enrollment, and engagement.
· Collaborate with other NSCH Navigators to ensure comprehensive patient care.
· Attend all required state and federal enrollment training sessions.
· Maintain certification as a Certified Application Counselor (CAC).
Non-Essential Functions:
Attends periodic staff meetings
Adheres to NSCH policies
Adheres to NSCH values and principles:
Mission
North Shore Community Health’s mission is to build healthy communities by providing exceptional care to all.
Vision
Healthy People | Vibrant Communities
Values
Accountability
We take our responsibility to ourselves, each other, and the NSCH Community very seriously. We understand our individual roles, and positions of power with respect to how others perceive our roles and actions. We hold ourselves accountable when we make mistakes–acknowledging the error, owning it, taking corrective actions, and moving forward. We follow through on what we commit or resolve to do.
Integrity
Integrity is the foundation of healthy relationships. We are committed to the highest ethical standards: honesty, fairness, respectfulness, and trustworthiness. We are honorable and respectful in dealings with others, and we strive to deal honestly, fairly and in a respectful, ethical, and trustworthy manner when in agreement or disagreement.
Empathy
Empathy is a deep appreciation for another’s situation and point of view, which is the basis for the golden rule and our intrinsic sense of justice. We strive to bring empathy into our interactions with each other and with our patients.
Courage
We see courage as the strength of character to stand up for our convictions and belief system. To have courage is to have the fortitude to take risks and to extend one’s behaviors, actions, and thoughts beyond one’s comfort zone. We appreciate that courage is often required to compromise. Courage is a state of mind to face adverse, difficult, and challenging situations with confidence and positive energy.
Respect
NSCH holds its patients in the highest regard. We provide care that is respectful of and responsive to individual patient needs and values. We take the time to listen to concerns, understand what is important, and provide appropriate solutions and care. We do this through coordination and integration of care, collaboration, and teamwork.
Commitment
NSCH is committed to the health and well-being of its community, patients, and staff. We demonstrate this commitment by constantly striving to align our actions with our mission, vision, and values.
EEO Statement:
We, North Shore Community Health (NSCH), are an equal employment opportunity employer. Our goal is to have a diverse workforce representative of all people, at all job levels, in the organization. We do not and will not make any personnel decisions (like recruiting, hiring, job assignments, and promotions) based on age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity, gender expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.
https://www.nschi.org/wp-content/uploads/2022/03/nsch_eeo-policy-statement-dec-2021.pdf
Requirements
High school diploma or equivalent
At least one year of experience in non-profit or healthcare work, preferably in assisting community members in program enrollment.
Third party billing or medical reception experience strongly preferred
Willingness to receive CAC certification within 3 months of employment
Working knowledge of insurances – specifically MassHealth – strongly preferred.
Fluency in English AND either Spanish or Portuguese
Demonstrated strong communication skills with individuals and/or groups
Proficiency in Microsoft Office applications (Excel, Word, PowerPoint)
Experience working in Epic is strongly preferred
Valid MA driver’s license
Maintains strict adherence to the NSCH Confidentiality policy
Incorporates NSCHI values, principles and mission statement into daily activities
Complies with all NSCHI personnel policies and procedures
Strong analytical, problem solving, planning and prioritization skills
Self-motivated and self-directed to work within a team and/or work independently
Extremely detail-oriented in both verifying own work as well as the work of others