Patient Navigator - Social Care Network (10 month position)

Overview

St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.

 

St. John’s has been an integral part of the community since the 1890's and its’ commitment to provide the community with the most advanced medical services available continues to be the hospitals’ vision, mission and value. St. John's Riverside Hospital built itself around an early foundation of nursing and community service. In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St. John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John’s dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.

 

St. John’s Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.

 

St. John’s Riverside Hospital  is an equal opportunity employer. We maintain a policy of non-discrimination in providing equal employment to all qualified employees and candidates regardless of race, creed, color, national origin, sex, age, disability, marital status, or other legally protected classification in accordance with applicable federal, state, and local law.

 

Personalized care together with advanced technology is what it means to be Community Strong

Responsibilities

12 month position

 

The Social Care Network (SCN) Patient Navigator is responsible for supporting community members experiencing a range of Social Determinants of Health (SDOH) challenges by connecting them to resources that improve their overall health and well-being. This position plays a key role in St. John’s Riverside Hospital’s (SJRH) participation in New York State’s Medicaid 1115 Waiver by conducting SCN eligibility screenings, completing assessments, and providing social care navigation services for Medicaid recipients in Westchester County.

 

Responsibilites

Identify eligible patients within the hospital system for SCN screening.

• Verify active Medicaid status through ePACES.
• Confirm in Unite Us that a screening has not been completed.
• Confirm the presence of a qualifying “life event change” before conducting a re-screening within one year.

Conduct SCN initial screenings using the standard tool available in Unite Us or the hospital Electronic Medical Record (EMR) system.

Deliver screening and navigation services in accordance with 1115 Waiver requirements and SCN protocols.

Complete Eligibility Assessments to determine whether patients qualify for Enhanced Services through the region’s Social Care Network.

Provide navigation and care management services as appropriate, based on screening and eligibility assessment results.

Travel independently between multiple facilities (Yonkers, Dobbs Ferry, Mt. Vernon, and Greenburgh) to administer SCN screenings.

Meet SCN Key Performance Metrics (KPIs):

• Minimum of 251 screenings per month
• Year-to-date screening targets
• Number and percentage of assessments completed
• Number of patients deemed eligible for Health-Related Social Needs (HRSN) services
• Number of patients successfully connected to community resources

Conduct timely outreach and deliver navigation services in collaboration with hospital and community-based staff.

Manage screenings, referrals, and invoicing through the Unite Us and EMR platforms, maintaining accurate and timely documentation.

Collaborate with the supervisor to adjust workflows and implement programmatic changes based on evaluation outcomes and evolving state or local priorities.

Qualifications

• High School Diploma or equivalent
• Fluent in English and Spanish required.
• Ability to meet travel requirements associated with this position is required.
• Valid driver’s license required.
• Access to personal car for work-related travel required
• Computer Skills and a willingness to learn new web-based platforms / EMRs required.
• Ability to work independently with a minimum supervisor oversight