COMMUNITY RESOURCE NAVIGATOR

Job Title: Community Resource Navigator

Department: Outreach and Navigation

Reports To: Outreach and Navigation Manager

FLSA Status: Non-Exempt

Summary:

The Community Resource Navigator is a vital member of NOHN's patient-centered medical home and integrated care team. This position supports patients in overcoming social, economic, cultural, and non-clinical barriers that impact health outcomes and access to care. The Community Resource Navigator connects patients with community resources and support services that address social drivers of health, including food security, housing stability, transportation, health insurance coverage, financial assistance, employment support, and other essential needs.

Working collaboratively with providers, behavioral health professionals, care coordinators, and community partners, the Community Resource Navigator helps patients navigate complex systems, access available resources, and develop self-sufficiency whenever possible. This role supports NOHN's mission of providing equitable, accessible, and comprehensive healthcare to all members of the community.

Essential Functions and Responsibilities

Patient Navigation and Resource Coordination

• Conduct screenings and assessments to identify social, economic, and environmental barriers affecting patient health and well-being.

• Assist patients in accessing resources related to:

• Food assistance and nutrition programs

• Housing and homelessness services

• Utility and energy assistance programs

• Transportation services

• Employment and vocational support programs

• Childcare and family support services

• Community education programs

• Legal and social service resources

• Financial assistance and prescription support programs

• Educate patients regarding community resources, eligibility requirements, and application processes.

• Assist patients with completing applications, forms, and required documentation for community resources and benefit programs.

• Support patients in obtaining and maintaining health insurance coverage, including Washington Healthplanfinder and other public assistance programs.

• Facilitate referrals and warm handoffs to internal and external resources to ensure continuity of support.

• Provide follow-up and ongoing engagement to assist patients in successfully connecting with recommended services. Tracking referral outcomes and barriers to successful service connections.

• Maintain active caseloads of patients requiring intensive navigation and support.

Care Team Collaboration

• Partner with providers, nursing staff, behavioral health clinicians, care coordinators, and other members of the healthcare team to identify and address patient resource needs.

• Participate in interdisciplinary care team meetings as appropriate.

• Document patient interactions, interventions, referrals, and outcomes accurately and timely within the electronic health record (EHR).

• Communicate barriers, resource gaps, and patient concerns to appropriate care team members.

Community Engagement and Resource Development

• Maintain current knowledge of community resources, eligibility requirements, and referral pathways and processes throughout Clallam and Jefferson Counties and surrounding service areas.

• Develop and maintain positive working relationships with community agencies, social service organizations, schools, government programs, and local nonprofits.

• Collaborate with Community Outreach staff to identify resource gaps and opportunities for partnership development.

• Represent NOHN professionally within the community and at community events, resource fairs, and outreach activities as assigned.

Health Fairness and Patient Advocacy

• Advocate for patients experiencing barriers to healthcare access.

• Promote culturally responsive, trauma-informed, and patient-centered approaches in all interactions.

• Support patient self-sufficiency and self-advocacy, when appropriate, through education and resource navigation.

• Support NOHN's efforts to reduce health disparities and improve health outcomes among underserved populations.

• Respect and protect patient confidentiality in accordance with HIPAA and organizational policies.

Other Duties

• Participate in required trainings, quality improvement initiatives, and organizational meetings.

• Perform other duties as assigned to support department and organizational goals.

Core Competencies

• Patient Advocacy

• Cultural Humility and Inclusivity

• Community Resource Knowledge

• Relationship Building

• Effective Communication

• Problem Solving

• Organization and Time Management

• Adaptability

• Collaboration and Teamwork

• Professionalism and Integrity