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 client's 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 Driver's 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.