Substance Use Disorder (SUD) Community Navigator

Salem, MA (http://maps.google.com/maps?q=47+Congress+Street+Salem+MA+USA+01970)

Job Type

Full-time

Description

THE ORGANIZATION

North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the surrounding communities with comprehensive and culturally sensitive care. With a strong commitment to excellence, NSCH provides:

• Comprehensive primary care.

• Dental services.

• Behavioral health care.

• Care management.

• Pharmacy services.

• Substance Use Recovery Services

• Nurse care management.

• Insurance enrollment assistance.

NSCH operates service sites at Gloucester, Peabody, and Salem Family Health Centers, ensuring convenient access to care. Additionally, NSCH extends its reach through school-based health centers within the Salem and Peabody School Districts. NSCH collaborates with Bentley Academy, Collins Middle School, Horace Mann School, Bates Elementary School, and the Peabody Learning Academy for behavioral health services.

As a community-based safety net healthcare provider, NSCH actively encourages diversity and welcomes staff members who reflect the rich tapestry of our communities. We highly value the contributions of our team members and offer a wide range of perks and comprehensive benefits. These include health and wellness benefits, tuition reimbursement, loan forgiveness opportunities, and other appealing benefits.

We believe in supporting our employees from day one, and all eligible staff members can take advantage of these benefits right from the start of their employment at NSCH. We aim to foster a supportive and rewarding environment that empowers our team members to provide exceptional care to our communities.

Primary Purpose of Position:

North Shore Community Health (NSCH) is an industry leader in exceptional community healthcare delivery. Under the supervision of Director of Recovery Services , the SUD Community Navigator will join the SUD treatment team at NSCH, working closely with Mass General Brigham Salem Hospitals ED and Bridge Clinic to work in a collaborative way through coordination and continuity of care. The goal of the SUD Community Navigator is to connect patients who present in the ED or Bridge Clinic back to the Health Center in a seamless manner to promote better health outcomes. Ensuring proper insurance status, ACO, and enrollment in the EMR through Outreach and Enrollment will be a key responsibility in this role. The SUD Community Navigator will join a team at NSCH which serves over 400 patients currently in care for opioid use disorder. Our team includes physicians, nurse practitioners and physician assistants, RN care managers, BH clinicians and a Recovery coach. The SUD Community Navigator will serve as the main point of contact between MGB Salem and NSCH for persons who live with substance use, and in need of medical care.

Essential Functions:

• Will assist patients withthe Outreach and enrollment processby ensuring those who will be following up with NSCH have accepted MassHealth insurance form , correct ACO, relevant PCP listed. This role will beassisting patients throughout this process

• SUD Community Navigator will help to identify patients who present to ED/Bridge Clinic for any Substance Use related events and screen them for social determinants needs ( food insecurity, violence/safety, transportation, housing, etc.) through several means: ADT Feed and/or other tracking feeds, as well as Care Management Teams, which determine NSCH patients presenting to Highter Level of Care.

• By those patients identified in above, the SUD Community Navigator will either connect patients back to their Primary Care Team or assist them in establishing with a new PCP at the Health Center , and provide timely follow-up appointments after hospital discharge.

• Will assist in connecting patient to additional community service providers if appropriate

• Coordinate and manage initial follow-up appointments post ED / Bridge Clinic discharge/presentation

• Provide continued outreach for patients that are difficult to engage , who may be missing their initial follow-up appointments with their NSCH medical team, by making all appropriate attempts at outreach over a 72 hour period to reschedule missed appointment.

• Collaborate with SUD Recovery Team at NSCH and SUD Team at MGB Salem as appropriate

• Document encounters and all necessary information in Electronic Medical Record (EMR)

• Track patients who have been established with the SUD Community Navigator as well as patients that have completed an initial follow-up as well as patients who have refused/declined/did not attend appointment

• Provide culturally competent care to patients by using interpreter services, when needed.

• Support patients by using motivational interviewing techniques, trauma informed care, and non stigmatizing language.

• Collaborates with SUD treatment team to establish and engage patients in care regardless of their stage of recovery

• Works with patients to troubleshoot both internal and external barriers to treatment and recovery goals

• Serves as point of contact between external agencies including local hospitals, Overdose Education and Narcan distribution programs, Correctional facilities, and transitional care facilities

• Works with NSCH team to develop systems for rapid, respectful and discrete registration and initiation of care

• Collaborates with community organizations and stake holders to expand and improve services

• Works with SUD treatment team to increase equity and inclusion in SUD treatment services

• Works with NSCH and MGB Salem’s teams to monitor and achieve progress towards programmatic goals by serving as a point of contact for the hospital and for patients who are being discharged

• Willingness to provide cross-coverage in duties between SUD Navigators and Recovery Coach

• Willingness to travel between sites: Salem, Peabody, and Gloucester

• Cross trained to assist with some Medical Assistant duties and tasks as needed

• Other duties as assigned

Non-Essential Functions:

• Attends periodic staff meetings

• Adheres to NSCH policies

• Adheres to NSCH values and principles:

Mission

North Shore Community Health’s mission is to build healthy communities by providing exceptional care to all.

Vision

Healthy People | Vibrant Communities

Values

Accountability

We take our responsibility to ourselves, each other, and the NSCH Community very seriously. We understand our individual roles, and positions of power with respect to how others perceive our roles and actions. We hold ourselves accountable when we make mistakes–acknowledging the error, owning it, taking corrective actions, and moving forward. We follow through on what we commit or resolve to do.

Integrity

Integrity is the foundation of healthy relationships. We are committed to the highest ethical standards: honesty, fairness, respectfulness, and trustworthiness. We are honorable and respectful in dealings with others, and we strive to deal honestly, fairly and in a respectful, ethical, and trustworthy manner when in agreement or disagreement.

Empathy

Empathy is a deep appreciation for another’s situation and point of view, which is the basis for the golden rule and our intrinsic sense of justice. We strive to bring empathy into our interactions with each other and with our patients.

Courage

We see courage as the strength of character to stand up for our convictions and belief system. To have courage is to have the fortitude to take risks and to extend one’s behaviors, actions, and thoughts beyond one’s comfort zone. We appreciate that courage is often required to compromise. Courage is a state of mind to face adverse, difficult, and challenging situations with confidence and positive energy.

Respect

NSCH holds its patients in the highest regard. We provide care that is respectful of and responsive to individual patient needs and values. We take the time to listen to concerns, understand what is important, and provide appropriate solutions and care. We do this through coordination and integration of care, collaboration, and teamwork.

Commitment

NSCH is committed to the health and well-being of its community, patients, and staff. We demonstrate this commitment by constantly striving to align our actions with our mission, vision, and values.

EEO Statement:

We, North Shore Community Health (NSCH), are an equal employment opportunity employer. Our goal is to have a diverse workforce representative of all people, at all job levels, in the organization. We do not and will not make any personnel decisions (like recruiting, hiring, job assignments, and promotions) based on age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity, gender expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.

https://www.nschi.org/wp-content/uploads/2022/03/nsch_eeo-policy-statement-dec-2021.pdf

Requirements

• Associates or Bachelor’s degree preferred High School degree required

• Experience working with persons who live with substance use

• Experience working in a clinical setting, EHR, and/or as a care coordinator

• Experience working in a fast-paced ED or Urgent Care setting

• Bilingual preferred (Spanish/English).

• Excellent customer service, communication and organizational skills

• Experience in community outreach and program support

• Maintains strict adherence to the NSCH Confidentiality policy.

• Incorporates NSCH Guiding Principles and Mission Statement into daily activities.

• Complies with all NSCH personnel policies and procedures.

• Strong analytical, problem solving, planning and prioritization skills.

• Extremely detail-oriented in both verifying own work as well as the work of others.

• Must have reliable transportation to get to other sites and meetings as needed

NSCH ensures that all employees comply with the annual requirements for vaccinations and health screenings. All employees must be vaccinated against COVID-19 as a condition of their employment unless they have been granted a religious or medical exception. Proof of COVID-19 vaccination must be provided, and prospective employees must be vaccinated before their first day of employment, submitting their vaccination record and prehire paperwork. If you need to request an exemption from the vaccine requirement or have any inquiries regarding this policy, please get in touch with the Human Resources Department at hr@nschi.org.

At North Shore Community Health, our commitment lies in fostering a diverse workforce. If you're enthusiastic about this position but feel that your previous experience aligns differently with every requirement in the job description, we still encourage you to apply! Your skills could be a great fit for this role or other opportunities within North Shore Community Health.

Physical Requirements:

This job is inherently sedentary, necessitating the ability to remain seated or standing for extended durations, while also utilizing computers and phones. There may be a requirement to travel to multiple locations throughout the day.

Internal and External Contacts:

• Actively engages with employees through frequent face-to-face interactions, phone conversations, and email communication.

• Regularly interacts with external patients in person and through email and phone.

Reporting Structure:

This position reports to the Medical Director