Patient Navigator (Healthy Texas Women)

DESCRIPTION: The Patient Navigator provides individualized assistance to women and families to help overcome barriers and facilitate timely access to preventive and primary health services across multiple System Agency-administered programs. These include but are not limited to:

• Healthy Texas Women (HTW)
• Medicaid
• Family Planning Program (FPP)
• Primary Health Care (PHC)
• Breast and Cervical Cancer Services (BCCS)

Patient Navigators conduct assessments assist with eligibility and enrollment support application processes provide resource referrals and follow-up on service delivery and outcomes. They help individuals navigate non-medical and systemic barriers and are responsible for accurate documentation follow-through and coordination of care across programs.

SUPERVISION: Directly supervised by Program Coordinator.

TYPICAL PHYSICAL DEMANDS: Requires prolonged sitting stooping and bending. Occasional standing. Must be able to lift/carry up to 25 pounds. Requires the use of office equipment such as computer telephone copiers and scanners.

ESSENTIAL FUNCTIONS:

Navigation & Client Support:

• Perform comprehensive needs assessments including screening for non-medical service barriers using an approved assessment tool.
• Identify and help resolve barriers to preventive and primary health services (e.g. transportation translation financial social support).
• Provide culturally competent assistance ensuring communication is in the clients preferred language and accessible to individuals with limited English proficiency or disabilities.
• Offer application and enrollment support for multiple health programs including HTW Medicaid FPP PHC and BCCS.
• Follow up with individuals provided application assistance regardless of eligibility outcome; document refusal loss to follow-up or good faith efforts (minimum three contact attempts).
• Assist in creating individualized service plans and coordinate related support services.
• Track and document contact efforts client progress and referral outcomes using internal systems (e.g. Med-IT patient logs).
• Ensure timely follow-up for abnormal screening results (within 30 days) and cancer diagnoses (within 14 days).
• Monitor client care status and follow-up at intervals defined by program requirements.
• Document verbal or written informed refusals where applicable.

Coordination & Compliance:

• Coordinate referrals and services such as transportation translation appointment scheduling and treatment access.
• Maintain a program-specific resource directory detailing support services available to clients across all eligible programs.
• Ensure all navigation activities meet compliance with System Agency program policies.
• Support and track MBCC referrals and follow-up with clients not meeting eligibility criteria.
• Monitor and update patient status including resolution of identified barriers and service outcomes.
• Ensure documentation is complete timely and audit-ready.
• Maintain confidentiality and compliance with HIPAA and professional standards.
• Complete Case Assistance Navigator trainings as required by HHSC.
• Performs other duties as assigned.

SECONDARY FUNCTIONS:

• Prepare and compile program data logs and reports as required.
• Enter and manage patient information in electronic and physical record systems.
• Participate in community education and outreach efforts as requested.
• Support administrative functions including correspondence scheduling and promotional activities.
• Attend trainings staff meetings and supervisory sessions; contribute to team goals and collaboration.

MINIMUM QUALIFICATIONS:

• Must be a graduate from an accredited high school or GED program.
• Two years experience preferably in a community health care setting.
• Must be certified by HHSC/CPP within 30 days from hire date prior to providing application assistance and case management services to individuals.
• Bilingual in English and Spanish is preferred.
• Possess means of transportation.
• Valid Texas Drivers License and minimum liability insurance.

SKILLS AND ABILITIES:

• Strong knowledge of eligibility processes for public health programs (HTW Medicaid BCCS FPP PHC).
• Effective communication and documentation skills both oral and written.
• Ability to establish rapport with diverse populations and maintain cultural sensitivity.
• Understanding of HIPAA and client confidentiality standards.
• Proficient in problem-solving client engagement and community resource development.
• Ability to work independently and within interdisciplinary teams.
• Capacity for clear judgment time management and meeting deadlines.