ECM and CSS Peer Navigator, Street Medicine (San Fernando Valley, CA)

Healthcare in Action; San Fernando (CA); On-site; USD 29,000 - 45,000; Full time

Benefits offered by this job

Base pay range documented

Annual bonus program

Wellness program

Generous PTO

11 paid holidays + floating holiday

401(k) with employer match

Recognition program

Tuition reimbursement

Team impact

Job summary

Healthcare in Action is seeking a Peer Navigator to support members experiencing homelessness in the San Fernando Valley area, delivering education, housing and resource navigation, and peer support. This is a full-time, field-based role with a 8-5 schedule, Monday-Friday.

The role involves guiding members to services, coordinating care with ECM and CalAIM Community Supports, and occasional van driving. Experience with homelessness, mental health or substance use conditions is valued.

Qualifications

• G.E.D./High School, required plus 3+ years of work experience.
• Associate's Degree plus 2+ years of work experience.
• Bachelor's degree preferred plus 1+ years of work experience.
• Work Experience to include direct work experience, lived experience, training or volunteer work with patients experiencing homelessness, as well as those with active mental health and substance use conditions.
• Other demonstrated relevant experience in similar community settings, for example, working with other disadvantaged groups, and/or outreach will be considered.
• A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.
• Ability to work in a dynamic, outdoors environment.
• Ability to work independently as well as part of a team.
• Ability to organize effectively.
• Ability to prioritize multiple and competing tasks.
• Ability to communicate effectively, including articulating one's own relevant personal experiences.
• Excellent oral communication skills, as well as strong interpersonal skills.
• Maintenance of reliable transportation
• Proficiency in operating a computer, including logging into and maneuvering around multiple systems such as online timesheets (time and attendance) and call center software.
• HMIS/ Coordinated Entry System, preferred.
• Travel 50% or more- Must have a valid driver's license, automobile insurance, reliable transportation, and clean driving record.

Responsibilities

• Build rapport with members by communicating personal experiences with a goal of increasing the likelihood of positive behavior changes.
• Coach members to create and implement strategies that minimize risks associated with the identified common health conditions and behaviors. Connect members to appropriate programs to address barriers to care and to enhance compliance.
• Link members to local, county and state services/resources. Follow up with members and serve as a member advocate, delivering their medications and other supplies as needed.
• Coordinate and/or accompany members to medical and social services appointments that fall outside of the street medicine unit.
• Introduce tools to promote self-management & self-efficacy.
• Complete all required organization and health plan specific documentation in a timely fashion. Some examples include and are not limited to the following: enter all patient touch points and encounter notes in HIA's electronic health records system, member health risk, and update members' Plan of Care after every street medicine encounter. Document all required information in the care management system during phone calls with members. Complete and submit a Monthly Audit Checklist assessment, individual care plans, and update member profiles in the Coordinated Entry System/HMIS.
• May occasionally drive the medically equipped van.
• Schedule encounters based on member's acuity level using the Healthcare in Action electronic health record system.
• Work under the supervision of a Social Worker to ensure proper escalation of cases and coordination of care.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
• Actively support the achievement of HIA's Vision and Goals and particularly housing placement for unsheltered members.
• This position is a patient-facing role.
• Employees may be eligible for differential pay.
• Other duties as assigned.

Skills

Communication skills

Interpersonal skills

Reliable transportation

Computer proficiency

Driver's license

Education

GED/High School

Associate's Degree

Bachelor's degree preferred

Tools

HMIS / Coordinated Entry System

Job description

At Healthcare in Action, we serve patients experiencing homelessness through an innovative "street medicine" approach by contracting with Medicare and Medicaid health plans as well as hospitals and health systems.

Street medicine entails using a medically equipped van to deliver medical care directly to people experiencing homelessness in locations such as parking lots, encampments, and parks.

The Peer Navigator supports members who are experiencing/ are at risk of experiencing homeless with managing their own health in San Fernando Valley, CA area. Assist in motivating behavioral changes in patients to improve health outcomes through education, peer support, housing & resource navigation, and the relaying of shared experiences.

This Peer Navigator role provides support with ECM, CSS.

Enhanced Care Management (ECM) is a statewide Medi-Cal benefit under the California Advancing and Innovating Medi-Cal (CalAIM) initiative. ECM provides a whole-person approach to care for high-need Medi-Cal beneficiaries, focusing on both clinical and non-clinical needs. The program includes a Lead Care Manager (LCM) who coordinates all healthcare-related needs and social services, advocating on behalf of the member. ECM aims to improve health and social outcomes by offering comprehensive care management and coordination services.

CSS also known as CalAIM Community Supports), which provide housing navigation, tenancy sustaining, and temporary or transitional housing supports through Medi-Cal.

**This is a full-time, Monday-Friday 8-5 position in the field.

Responsibilities include:

• Build rapport with members by communicating personal experiences with a goal of increasing the likelihood of positive behavior changes.

• Coach members to create and implement strategies that minimize risks associated with the identified common health conditions and behaviors. Connect members to appropriate programs to address barriers to care and to enhance compliance.
• Link members to local, county and state services/resources. Follow up with members and serve as a member advocate, delivering their medications and other supplies as needed.
• Coordinate and/or accompany members to medical and social services appointments that fall outside of the street medicine unit.
• Introduce tools to promote self-management & self-efficacy.
• Complete all required organization and health plan specific documentation in a timely fashion. Some examples include and are not limited to the following: enter all patient touch points and encounter notes in HIA's electronic health records system, member health risk, and update members' Plan of Care after every street medicine encounter. Document all required information in the care management system during phone calls with members. Complete and submit a Monthly Audit Checklist assessment, individual care plans, and update member profiles in the Coordinated Entry System/HMIS.
• May occasionally drive the medically equipped van.
• Schedule encounters based on member's acuity level using the Healthcare in Action electronic health record system.
• Work under the supervision of a Social Worker to ensure proper escalation of cases and coordination of care.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
• Actively support the achievement of HIA's Vision and Goals and particularly housing placement for unsheltered members.
• This position is a patient-facing role.
• Employees may be eligible for differential pay.
• Other duties as assigned.

Qualifications and experience:

• G.E.D./High School, required plus 3+ years of work experience as defined below.

• Associate's Degree plus 2+ years of work experience as defined below.

• Bachelor's degree preferred plus 1+ years of work experience as defined below.

• Work Experience to include direct work experience, lived experience, training or volunteer work with patients experiencing homelessness, as well as those with active mental health and substance use conditions.

• Other demonstrated relevant experience in similar community settings, for example, working with other disadvantaged groups, and/or outreach will be considered.

• A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.

• Ability to work in a dynamic, outdoors environment.
• Ability to work independently as well as part of a team.
• Ability to organize effectively.
• Ability to prioritize multiple and competing tasks.
• Ability to communicate effectively, including articulating one's own relevant personal experiences.
• Excellent oral communication skills, as well as strong interpersonal skills.
• Maintenance of reliable transportation
• Proficiency in operating a computer, including logging into and maneuvering around multiple systems such as online timesheets (time and attendance) and call center software.
• HMIS/ Coordinated Entry System, preferred.
• Travel 50% or more- Must have a valid driver's license, automobile insurance, reliable transportation, and clean driving record.

What's in it for you?

• Base salary range: $21.78 to $33.00 per hour
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match.
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

At Healthcare in Action, we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

Healthcare in Action is proud to be an Equal Employment Opportunity and Affimative Action workplace. Individuals seeking employee will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Healthcare in Action was established in 2021 as a 501 (c)3 organization and associated medical group. Utilizing mobile clinics staffed by healthcare professionals, community health workers, and social workers, our teams travel directly to unhoused individuals living in communities across the geographies we serve, providing services where they reside - including tents, cars, shelters, and temporary housing. In meeting patients where they are and supporting their goals, HIA team members build trust - a critical component that can lead to meaningful and positive changes in health and housing. Our mission is to improve the lives of people experiencing homelessness through quality holistic care. It is our vision that all people experiencing homelessness have access to quality healthcare that addresses their mental, social and physical health needs.