Dementia Care and Caregiver Support Navigator

Bay Aging; Urbanna (VA); Hybrid; USD 48,000 - 55,000; Full time

Job summary

Bay Aging seeks 2 full-time Dementia Care Navigators to be the primary contact for beneficiaries living with dementia and their caregivers under the GUIDE model. The navigator manages a caseload, coordinates medical and community services, and maintains person-centered care plans across the care continuum.

These roles report to the Community Living Programs Director, require strong care coordination, and involve travel within the Northern Neck and Middle Peninsula.

Qualifications

• Strong care coordination, case management, assessment, care planning, and follow-up skills.
• Knowledge of dementia, caregiver needs, safety concerns, and community resources.
• Ability to communicate effectively with people living with dementia, caregivers, healthcare providers, and community partners.
• Ability to develop care plans and maintain accurate, timely case notes and program records.
• Ability to recognize changes in condition, caregiver concerns, and urgent safety issues and follow established reporting procedures.

Responsibilities

• Serve as the primary contact for GUIDE beneficiaries and caregivers, managing referrals and caseload.
• Coordinate comprehensive assessments, home visits, and reassessments.
• Develop and share beneficiary-led, person-centered care plans and maintain them in the EHR.
• Manage contacts with beneficiaries and caregivers to monitor progress toward goals.
• Coordinate with providers and community resources, including Medicaid when applicable.
• Provide dementia education, caregiver support, and referrals to trainings and groups.

Skills

Care coordination

Case management

Assessment

Care planning

Communication

Education

Healthcare-related degree preferred

Tools

EHR systems

Microsoft Office

Video conferencing

Job description

Bay Aging seeks 2 full-time Dementia Care Navigators to be the primary contact for beneficiaries living with dementia and their caregivers under the GUIDE model. The navigator manages a caseload, coordinates medical and community services, and maintains person-centered care plans across the care continuum.

These roles report to the Community Living Programs Director, require strong care coordination, and involve travel within the Northern Neck and Middle Peninsula.