Integrated Care Navigator

Washington County Mental Health Services; Montpelier (VT); On-site; USD 48,000 - 60,000; Full time

Job summary

Washington County Mental Health Services is seeking an Integrated Care Navigator to help clients access behavioral health, primary care, and community resources. You will coordinate referrals, support follow-up, and work with interdisciplinary teams to ensure seamless, well-coordinated care.

Ideal candidates will have experience in healthcare or social services, strong organizational and communication skills, and the ability to travel locally as needed.

Responsibilities

• Coordinate referrals and monitor follow-up to ensure clients access needed services.

Job description

Washington County Mental Health Services (WCMHS) is seeking a compassionate, organized, and proactive Integrated Care Navigator to help clients successfully access and navigate behavioral health, primary care, and community-based services.

As an Integrated Care Navigator, you'll serve as a vital connection between clients, healthcare providers, and community resources. Working alongside interdisciplinary care teams, you'll coordinate referrals, support follow-up care, remove barriers to services, and help ensure clients receive seamless, well-coordinated care.

This is an excellent opportunity for someone who enjoys building relationships, solving problems, and making a meaningful impact on the health and well-being of others.

What You’ll Do

Coordinate Client Care

• Support clients in navigating behavioral health, primary care, specialty care, and community resources.
• Coordinate referrals and monitor follow-up to ensure clients successfully access needed services.
• Work closely with clinicians, case managers, nurses, primary care providers, hospitals, and community organizations to facilitate coordinated care.
• Participate in interdisciplinary team meetings and care planning discussions.
• Assist clients in overcoming barriers to care, including transportation, insurance, appointment scheduling, and community resource access.

Support Referrals & Care Transitions

• Initiate, track, and follow up on referrals to internal and external providers.
• Coordinate medical records requests and ensure appropriate Releases of Information (ROIs) are current.
• Help maintain closed-loop referrals by confirming services have been received and documented.
• Monitor missed appointments and complete outreach to reconnect clients with care.

Connect Clients with Benefits & Resources

• Help clients determine eligibility for Medicaid, Medicare, Veterans benefits, SNAP, transportation, and other available community resources.
• Assist clients with benefit applications and connect them to appropriate support services.
• Identify clients who may benefit from specialty services and coordinate those connections.

Documentation & Care Coordination

• Maintain accurate, timely documentation within the electronic medical record (EMR).
• Ensure client records remain current, including provider information and required releases.
• Track referrals, follow-up activities, and care coordination tasks.
• Maintain compliance with HIPAA, confidentiality requirements, and agency policies.

Intake & Administrative Support

Depending on program needs and training, this role may also:

• Support intake appointments and care team workflows.
• Collect client information and complete required documentation.
• Record basic health information and routine vital signs.
• Prepare and route information to clinical and administrative staff for follow-up.

Required Qualifications

• High school diploma or GED.
• Experience in healthcare, behavioral health, care coordination, case management, social services, or a related field.
• Strong organizational and time management skills with the ability to manage multiple priorities.
• Excellent communication and relationship-building skills.
• Proficiency with Microsoft Office, including Outlook, Word, and Excel.
• Ability to learn and effectively use electronic medical record (EMR) systems.
• Valid driver's license and ability to travel locally as needed.

Preferred Qualifications

• Associate degree in Human Services, Healthcare Administration, Social Work, or a related field (or equivalent experience).
• Experience coordinating care within behavioral health, medical, or community-based settings.
• Knowledge of Medicaid eligibility, healthcare benefits, and community resource navigation.
• Experience working with interdisciplinary healthcare teams.
• Familiarity with electronic medical record systems and healthcare documentation.
• Experience using a client-centered and trauma-informed approach to service delivery.

What Makes You Successful

• Strong organizational skills with exceptional attention to detail.
• Ability to build trusting relationships with clients and community partners.
• Excellent problem-solving and critical thinking abilities.
• Compassionate, client-focused approach to care coordination.
• Ability to prioritize multiple tasks in a fast-paced environment.
• Strong written and verbal communication skills.
• Collaborative mindset and commitment to teamwork.

Working Conditions

This position is primarily office-based with frequent computer, phone, and video communication. Local travel within the community may be required to support client needs, attend meetings, or coordinate services.

Why Join Washington County Mental Health Services?

At WCMHS, you'll become part of a mission-driven team committed to improving the lives of individuals and families throughout Central Vermont. As an Integrated Care Navigator, you'll play a critical role in helping clients successfully access healthcare, behavioral health services, and community resources while supporting a truly integrated approach to care.