Patient Care Navigator II, Enhanced Care Management

Description
The Patient Care Navigator II is a role that blends care coordination responsibilities with community engagement. This role supports the Cal AIM Enhanced Care Management (ECM) program and maintains an assigned caseload. Patient Care Navigator II provides care coordination, connection to medical, behavioral health, and social services, and ongoing engagement to support members' needs.

The Patient Care Navigator II works closely with RN Care Managers (RNCM), Licensed Vocational Nurses (LVNs), Behavioral Health Care Managers (BHCM), Community Health Workers (CHWs), Health providers, and community partners to ensure appropriate access to care.

FLSA Status

Exempt

Salary Range

$23.00-$27.00

Reports To

ECM Program Manager / Director

Direct Reports

No

Location

Los Angeles Onsite

Travel

Up to 80%

Work Type

Regular

Schedule

Full Time

Position Description
Care Coordination & Caseload Management

• Maintain an assigned caseload of ECM Members in accordance with Medi-Cal guidelines
• Provide ongoing outreach, engagement, and follow-up with members via phone and in-person visits, based on assigned tier level and member need
• Conduct face-to-face visits as required by member risk tier
• Provide care coordination support, including appointment scheduling, transportation arrangements, referral tracking, and follow-up
• Ensure smooth transitions of care, including coordination with hospitals and facilities related to admissions and discharges
• Engagement & Member Support
• Utilize motivational interviewing to engage members in care
• Connect members to community resources and social services, including housing, food, transportation, and other identified needs
• Promote member self-efficacy and shared decision-making in care planning
• Clinical Collaboration & Team Support
• Collaborate with RNCMs, LVNs, BHCMs, CHWs, and other care team members regarding members' care needs
• Support care team members with delegated clerical tasks as appropriate
• Program Operations & Documentation
• Assign members to appropriate Case Managers based on risk category and available clinical data
• Track and ensure completion of required assessments and screenings, including Health Assessments and Shared Care Plans
• Maintain timely, accurate documentation in the ECM care management platform in compliance with program requirements

Additional Responsibilities

• Attend meetings with providers, health plans, community partners, and internal stakeholders
• Complete additional tasks and projects assigned to support ECM program goals

Qualifications

• High school diploma or equivalent required; Associate's or bachelor's degree in health administration, Public Health, Social Work, Sociology, Psychology, or related field preferred
• Experience in care coordination, community health work, case management, or social services
• Experience working with high-risk or vulnerable populations
• Strong interpersonal, organizational, and communication skills
• Ability to manage a caseload and prioritize multiple tasks in a fast-paced environment
• Comfortable with field-based, community, and home visits
• Proficiency with electronic health records and care management platforms
• Reliable transportation with active insurance coverage
• Preferred Qualifications
• Experience working within CalAIM, ECM, managed care, or Medicaid programs
• Knowledge of community-based resources and social service systems
• Bilingual abilities preferred

Benefits
As a firm passionate about health care, we're deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities and a paid parental leave program. You can learn more about our benefits offerings here:

About COPE Health Solutions
COPE Health Solutions is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers, health plans and self-insured employers. For more information, visit

To Apply
To apply for this position or for more information about COPE Health Solutions, visit us