QI-VBC Patient Navigator

Family Medical and Counseling Service; Washington (District of Columbia); Hybrid; USD 40,000 - 60,000; Full time

Job summary

Family Medical and Counseling Service in Washington, DC is seeking a Patient Navigator to support population health efforts within a Federally Qualified Health Center. You will engage with assigned patients through Managed Care Organizations to improve access to healthcare services and assist with Medicaid eligibility.

This role requires strong communication skills, healthcare outreach experience, and the ability to navigate community resources. Regular hours are Monday to Friday with a telework option up to 50%.

Qualifications

• Experience in healthcare outreach, Medicaid enrollment, patient navigation, or community health preferred.
• Knowledge of Medicaid and Managed Care Organizations (MCOs) preferred.
• Ability to work collaboratively with diverse populations.

Responsibilities

• Assist patients with Medicaid recertification and renewal applications.
• Educate patients on required documents, deadlines, and eligibility.
• Track outreach attempts and patient responses in the EMR.

Skills

Healthcare Outreach

Customer Service

Organizational Skills

Communication Skills

Education

Associate or Bachelor’s degree in health administration, public health, social work, or related field

Tools

EClinicalWorks

Microsoft Office

Job description

POSITION SUMMARY

The Patient Navigator supports population health and care coordination efforts within a Federally Qualified Health Center by engaging attributed patients assigned through Managed Care Organizations (MCOs), improving access to preventive and primary care services, and assisting patients with Medicaid eligibility maintenance, recertification, and reenrollment. This role helps advance value-based care goals by reducing barriers to care, improving patient outcomes, and supporting continuity of insurance coverage. This is a 6-12 month position.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assist patients with Medicaid recertification, renewal applications, and reenrollment processes.
• Educate patients on required documents, deadlines, and eligibility requirements.
• Help patients complete applications and submit supporting documentation.
• Conduct outreach to patients attributed through Medicaid Managed Care Organizations (MCOs) to schedule primary care visits, annual wellness visits, preventive screenings, and follow-up appointments.
• Contact patients by phone, text, mail, and community outreach methods to encourage engagement in care.
• Educate patients on available health center services, benefits, and care coordination resources.
• Track outreach attempts and patient responses in the EMR (EClinicalWorks) and payer reporting systems.
• Assist in closing care gaps related to preventive screenings and chronic disease management.
• Monitor attributed patient panels to identify overdue services and support provider quality metrics.
• Collaborate with care teams to improve patient compliance with treatment plans and recommended services.
• Support initiatives tied to value-based payment contracts and quality performance targets.
• Identify social barriers affecting healthcare access, including transportation, food insecurity, housing instability, and language needs.
• Facilitate and schedule patient appointments/referrals and connect to internal/external community resources.
• Work closely with providers, case managers, social workers, and front desk staff to ensure continuity of care.
• Maintain accurate documentation of outreach, enrollment assistance, and patient encounters.
• Generate reports on outreach outcomes, recertification completion, and quality improvement efforts.
• Adhere to clinic departmental policies and procedures, which include Patient Safety initiatives, Patient Rights, and Health Insurance Portability and Accountability Act (HIPAA) Privacy standards.
• Support clinic quality improvement (QI) efforts. This includes clinic quality improvement and program monitoring, and directing Plan-Do-Study-Act (PDSA) change cycles.
• Attend relevant stakeholder and advisory meetings to support overall program implementation and evaluation.
• Attend external trainings and learning opportunities that expand content knowledge and best practices.
• Other duties as assigned.

HOURS OF WORK

Regular hours between 8:30 AM – 5:30 PM, Monday – Friday, with option of Telework (up to 50%).

REQUIRED QUALIFICATIONS, KNOWLEDGE & SKILL

• Associate or Bachelor’s degree preferred in health administration, public health, social work, or related field.
• Experience in healthcare outreach, Medicaid enrollment, patient navigation, or community health preferred.
• Knowledge of Medicaid, Managed Care Organizations (MCOs), and Federally Qualified Health Center operations preferred.
• Ability to work collaboratively with physicians, staff, and external organizations.
• Strong communication, customer service, and organizational skills.
• Ability to work with diverse populations and maintain confidentiality.
• Experience using electronic health records (EClinicalWorks) and Microsoft Office preferred.
• Proficiency with Microsoft Word and Excel.