PACE Participant Navigator (PPN)

PACE Participant Navigator (PPN) OC - Anaheim, CA 92801 Apply Overview Salary Range $16.50 - $22.00 Hourly Level Entry Position Type Full Time Job Shift Day Category Business Development Apply Description Who We Are To empower our senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support. Benefits 401(k) Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid sick time Paid time off Referral program Retirement plan Vision insurance Job Summary Under the direction of the Participant Relations Navigator, the PACE Participant Navigator (PPN) is responsible for answering a high volume of inbound calls and inquiries in a timely manner. Provides oversight of all communications coming into PACE from assigned participants and their caregivers in the form of phone calls, email, fax, letters, and in-person inquiries. Timely responses to all participant communications are essential. Must effectively prioritize workloads as new communication and tasks are submitted. Identify the participants' needs, clarify information, research issues, and provide solutions or alternatives whenever possible. Accurately and consistently document all conversations in the electronic database. This position is a liaison between the participant, Interdisciplinary Team (IDT) members, social work, RN case management and other PACE departments to resolve issues and ensure participant satisfaction. Essential Job Functions Duties include but are not limited to: Answer incoming calls, emails, and in-person requests for assistance in a timely manner in accordance with departmental performance targets and provide excellent customer service while doing so. May include assisting members in the PACE day center or clinic. Accurately and consistently document any expression of dissatisfaction, formal grievances or Service Delivery Requests and forward to the appropriate department for processing. Interface with Quality Improvement, Claims, Enrollment, Provider Relations, Clinic, Scheduling, Transportation, Social Work and other internal departments to provide excellent service to our participants. Research complex issues across multiple databases and work with support resources to resolve participant issues and/or partner with other departments to resolve escalated issues. Provide PACE program navigation assistance to Participants (PTPs) during and after the 8-10 week orientation period. Ensure that participants, families, and caregivers attain knowledge of PACE comprehensive health and psychosocial services, as well as PTP rights and responsibilities Assist PTPs to understand service delivery processes that include but are not limited to timely access to primary and specialty care, language interpreter services, medication management, access to day health center services, 24-hour nurse on-call services, homecare, and coordination of ED, Hospital, and SNF services. Assist in eliminating barriers to PACE services with advocacy and strategic navigation Provide ongoing education, with motivational interviewing techniques to help PTPs remain compliant at participating in biannual interdisciplinary reassessments and at fulfilling care plan goals Assist Social Workers to reduce and resolve PTP grievances, and prevent disenrollments. Conducts frequent follow-up phone calls to participants, family members, and caregivers, with home visits as needed. Provide escort assistance for offsite referral services as needed Assist with communication and coordination of care between PTPs and IDT members, including PTP Primary Care Providers Ability to pass PACE marketing exam within the first 60 days of employment. Provide assistance with intake processes as needed Able to demonstrate strong organizational skills. Adaptive with demonstrated ability to perform and prioritize multiple work tasks. Maintains a professional and positive attitude at all times. Demonstrates compliance with Innovative Integrated Health policies and procedures and

DHCS/CMS

regulatory requirements Attend and participate in staff meetings, in-services, projects, and committees as assigned. Adhere to and support the center's practices, procedures, and policies including assigned break times and attendance. Accept assigned duties in a cooperative manner; and perform all other related duties as assigned. Be flexible in schedule of hours worked. May require use of personal vehicle Qualifications Working Conditions and Physical Demands The working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to access all areas of the center throughout the workday. Requires constant hand grasp and finger dexterity; frequent sitting, standing, walking and repetitive leg and arm movements, occasional bending, reaching forward and overhead; squatting and kneeling. Ability to lift up to 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 25 pounds. Ability to communicate verbally, with an excellent comprehension of the English language. Work is generally performed in an indoor, well-lighted, well-ventilated, heated, and air-conditioned environment. Requirements Knowledge, Skills, and Abilities Bilingual Korean or Vietnamese Working knowledge of physical, mental, spiritual, and social needs of the frail elderly and their families. Effective management skills. Ability to work with ethnically diverse populations. Ability to apply creative problem-solving skills to the complex issues. Ability to work with interdisciplinary teams. Strong organizational skills, flexible, resourceful, and energetic. Effective oral and written communication skills.

Requirements and Education:

Valid Driver's license Automobile insurance verification Ability to engage in local travel Is medically cleared form communicable diseases and has all immunizations up-to-date before engaging in direct participant contact Minimum of one (1) of documented experience working with a frail or elderly population. Experience as a Community Health Worker or similar training preferred. Is medically cleared of communicable diseases and has all immunizations up-to-date before engaging in direct participant contact. Core Values CARE is central to what we do, prioritizing the well-being, dignity, and independence of our senior participants.

COMPASSION

in every interaction, ensuring kindness, empathy, and understanding guide our care. CULTURE that reflects the diverse backgrounds of those we serve and fosters a workplace where every team member feels supported, valued, and empowered to grow.

COMMUNITY

that fosters connection, belonging, and support for participants and their families.

COMMITMENT

to quality improvement, innovation, and delivering healthier outcomes. Share job details to