Bilingual Community Health Navigator II- San Francisco

MedZed; San Francisco (CA); Ibrido; USD 52.000 - 76.000; Tempo pieno

Descrizione del lavoro

MedZed is seeking a Community Health Navigator II to independently manage complex and high-acuity member cases through field visits and outreach in the community, prioritizing enrollment in primary care for Medicaid members. You will document care activities in Salesforce Health Cloud, coordinate referrals, and contribute to individualized care plans while ensuring CalAIM and DHCS compliance.

This full-time position is hybrid/remote and requires travel with a minimum of four in-field days per

Competenze

• High School Diploma or equivalent required.
• 2+ years' experience in ECM, case management, or community health.
• Ability to manage complex psychosocial and medical needs.

Mansioni

• Manage an ECM caseload up to 50+ members.
• Complete initial and follow-up ECM assessments including PHQ-9.
• Support development and updates of individualized Care Plans.
• Calls, field visits, and door knock to provide care and enroll new members.
• Document timely, accurate, and compliant case notes in Salesforce Health Cloud and health plan portals, as necessary.
• Coordinate referrals to health plans, providers, and community-based resources.

Conoscenze

ECM experience

Case management

Documentation

Field outreach

Compliance

Formazione

High School Diploma

Strumenti

Salesforce Health Cloud

Descrizione del lavoro

Position Title: Community Health Navigator II
Department : Operations
Reports To : ECM Territory Manager
Location : Hybrid/ Remote
Employment Type : Full-time
Travel requirement: This is a field-based position and requires substantial travel to meet with members where they live.

About MedZed

MedZed is a leader in delivering value-based, technology-enabled social support to a diverse population of high-cost Medicaid members who have been unreachable with telephonic outreach, disconnected from primary care, and using hospital-based services as their primary point of care. We combine innovative technologies with field-based outreach to find and engage these members. We then apply a model of care designed to re-connect them to primary care, address the Health-Related Social Needs (HRSNs) that contribute to their disengagement and present barriers to care, and provide them with the means and knowledge to take more control over their healthcare. Our interventions yield reduced Emergency Department and Inpatient utilization costs for our health plan partners and improved quality of life for their members.

Primary Focus

Independent field-based case management for moderate-to-high acuity members. To be effective, associates in this position will spend a substantial part of the work week visiting and enrolling members in the community.

Position Overview

The Community Health Navigator II (CHN II) is an ECM care manager responsible for managing complex and high-acuity member cases, serving as a mentor to newly hired care team staff, and modeling excellence in engagement, documentation, and compliance performance. The CHN II role is focused on developing foundational care coordination skills. CHN IIs are responsible for outreach (via door knocks and telephone), assessments, quality and billable care delivery and member graduations in compliance with CalAIM, DHCS, and contracted health plan requirements. This role is non-clinical in nature and is an in-field position minimum 4 days a week.

Key Responsibilities

• Manage an ECM caseload up to 50+ members.
• Complete initial and follow-up ECM assessments including Primary, Secondary, PHQ-9, and required reassessments.
• Support development and updates of individualized Care Plans
• Calls, field visits, and door knock to provide care and enroll new members.
• Build and maintain a member panel through consistent outreach.
• Coordinate referrals to health plans, providers, and community-based resources.
• Staff tables and other community partnership opportunities as requested.
• Document timely, accurate, and compliant case notes in Salesforce Health Cloud and health plan portals, as necessary.
• Participate in interdisciplinary case conferences and team huddles
• Escalate complex or high-risk member needs appropriately.
• Maintain compliance with CalAIM, DHCS, and health plan requirements.
• Meet outreach, engagement, and documentation standards.
• Attend required training and professional development.
• Support audit readiness and data tracking activities.
• Comply with all company policies and administrative requirements

Qualifications

• High School Diploma or equivalent required
• 2+ years' experience in ECM, case management, or community health
• Demonstrated excellence in documentation and compliance.
• Ability to manage complex psychosocial and medical needs.
• Curious and relentless nature
• Commitment to do outreach via phone and in-person to enroll new members.

Internal Promotion Criteria (CHN II -> CHN III)

• Serve as a CHN II for a minimum of 12 months.
• Maintain engagement, outreach, panel size, and quality metrics for at least six consecutive months.
• Be in good standing with no active corrective action.