Care Navigator

Position Status




NHC Position Type

Care Coordinator

Position Summary

DVCH is a community-focused health care organization with Patient Center Medical Home accreditation providing affordable and accessible primary medical, dental and behavioral health care. Services are provided in a fiscally responsible manner to all patients regardless of their ability to pay. As a Care Navigator at GMC, the member will be working with eligible patients to address preventative cancer screenings and to screen for and respond to pertinent social determinants of health (SDOH). GMC is one of our satellite sites and primarily serves patients receiving Medication Assisted Treatment (MAT) for substance use disorder. The position will include a significant amount of direct patient interaction and the ability to work with whole care teams (nurses, providers, health center managers, etc.). The member will be responsible for MAT-specific tasks such as running medications daily in the Prescription Drug Monitoring Program (PDMP) and re-engaging patients who have relapsed or have otherwise been lost to care. They may help with Covid-19 needs depending on the state of the pandemic.


Our NHC members are highly integrated with DVCH’s care teams, and generally take the role of follow-up on needs that providers and other care team members lack capacity for. The NHC member serves unmet needs by filling gaps in preventative healthcare and SDOH unable to be addressed by providers and staff. The NHC member will interact with vulnerable populations, namely those with substance use disorder, but also including seniors, people with chronic illness and disability, non-English-speakers, and people with no or low literacy.

Major Duties and Responsibilities

  • Practicing intake and referrals of patients in need
  • Identifying patients who are at-risk to assess eligibility for various services
  • Referring patients to other programs and community services tracking
  • Providing follow-up and case management to deliver assistance and information
  • Implementing patient engagement strategies to improve outcomes
  • Maintaining professional boundaries and respecting patient confidentiality
  • Auditing charts for quality assurance
  • Documenting interactions with patients in an electronic health record
  • Collaborating with supervisors and other leadership
  • Social determinants of health screener
  • Providing social service navigation

Characteristics of an Ideal Candidate

  • Organized; sound organizational skills
  • Multi-tasker; ability to balance
  • Detail-oriented
  • Comfortable speaking with patient populations, individually or in groups
  • Interested in health and wellness promotion
  • Experience interacting with patient populations
  • Team-oriented
  • Customer-oriented
  • Positive attitude
  • Patient and calm
  • Experience in interviewing or peer counseling
  • Good verbal and written communication skills
  • Proficient computer and data entry skills (e.g., Microsoft suite)
  • Knowledge of the disease process
  • Experience working with patient populations
  • Familiarity with patient populations
  • Speaks language(s) spoken by patient populations
  • Instills trust easily
  • Creative problem solving
  • Persistence
  • Resilience
  • Tenacity
  • Open-minded
  • Non-judgmental
  • Kind and friendly
  • Experience in a community health center or healthcare setting
  • Member serving at GMC should have lived or professional experience with people with substance use disorder, or an enthusiastic desire to learn about this patient population in what can at times be an emotional environment.

Knowledge Required for the Position

  • Knowledge of AmeriCorps/Health Corps member requirements
  • Skill with Microsoft Office or other software for a variety of data processing operations involving a range of problem solving, record keeping, correspondence, and service tracking options
  • Experience with or willingness to learn Excel and the RedCap data entry/management system.


  • Member uses initiative in carrying out recurring assignments following set procedures, independently.
  • The supervisor assigns service activities, advises on changes in procedures, and is available for assistance when required.
  • The supervisor assigns service activities in terms of project objectives and basic priorities and is available for consultation in resolving controversial issues.
  • Supervisors work with NHC members to establish broad goals based on percentage of time to be spent on each task, and check in weekly (initially, more frequently). NHC members take initiative to identify and prioritize patients day to day based on needs. The GMC member also serves closely with our MAT care coordinators.


  • The service activities are reviewed for accuracy through spot checks, through complaints from customers, and through observation of the Member at service.
  • The Member independently plans and carries out the projects and selects the approaches and methods to be used in solving problems.
  • Completed projects are reviewed very generally to determine that objectives have been met and are in compliance with policies and regulations.
  • Supervisors review individual member progress to ensure they are on track and are comfortable with assigned tasks, and discusses member performance with MAT care coordinators. Supervisors also evaluate team success on broad metrics.


  • Written and oral guides provide specific instructions for doing service.
  • Detailed guidelines exist, including regulations and directives, handbooks, precedents, industry standards and files of previous projects.
  • Guidelines are generally applicable, but the Member independently makes adaptations in dealing with problems and unusual situations.
  • Thorough written and oral guides exist, but COVID-19 and technological updates mean that processes change and members will come across outdated guidelines, or processes that are no longer efficient that they can assist with changing.


  • Member has little or no choice about how to perform the service position.
  • In making decisions, the Member is often required to depart from past approaches and to extend traditional techniques.
  • There is limited flexibility in the broad priorities of the role (MAT patient engagement; SDOH), but members may need to think outside the box for more efficient ways to navigate the assigned tasks as processes change.

Purpose and Impact of Service Position Assignments

  • The Member’s service output is necessary in order to facilitate the service of other staff.
  • Member provides timely services of a personal nature to others.
  • The service position product or service affects the accuracy, reliability, or acceptability of further processes or services.
  • The service position product or service affects the design or operation of systems, programs, or equipment.
  • The service position product or services affect the social, physical, and economic well-being of a substantial number of people on an ongoing basis.
  • The member is required to investigate or analyze a variety of unusual conditions, problems, or questions.

Nature of Contacts

  • Clients
  • Other DVCH employees and community organizations will also be frequent contacts

Purpose of Contacts

  • To provide customer service
  • Giving and exchanging information will also be commonly done with other DVCH employees. The member may resolve problems and motivate other staff as well.

Special Considerations

  • Service day for the GMC member begins at 7:30am. There are no evening/weekend/long shift expectations.
  • Spanish is preferred but not required.
  • Proof of COVID-19 Vaccination must be produced upon hire.