Memory Care Navigator

Williamsburg, Virginia Overview The Memory Care Navigator serves as a highly skilled, compassionate leader in dementia care coordination, delivering seamless navigation and support to individuals living with memory loss and their caregivers across clinical, community, and program-based settings. This role leverages a structured, patient and caregiver-centered approach encompassing intake and triage, education, resource coordination, and sustained engagement addressing the complex, evolving needs associated with cognitive decline. Serving as a central point of coordination, the Memory Care Navigator facilitates access to appropriate clinical and community resources, promotes continuity of care, and supports effective caregiving across the care continuum. Through strategic coordination, advocacy, and relationship-building, the Memory Care Navigator enhances care experiences, optimizes healthcare utilization, and drives meaningful improvements in quality of life for both individuals with memory loss and those who care for them. What you will do Proactively identifies, assesses, and manages patients and their families for care coordination across the continuum by gathering comprehensive clinical, psychological, social, and medical information from diverse sources. Evaluates patient needs and the appropriateness of healthcare services, facilitates access to resources and alternative levels of care, and engages patients and caregivers as active participants in the development and implementation of individualized care plans. Develops and implements individualized, patient-centered care plans in collaboration with patients, families, and the interdisciplinary healthcare team. Coordinates and facilitates care across the continuum by securing necessary approvals, ensuring appropriate referrals, and optimizing access to services. Guides patients and caregivers through the healthcare system to effectively utilize available resources and achieve established short- and long-term care goals. Advocates for patients and caregivers by ensuring appropriate education, engagement, and support throughout the care continuum. Collaborates with primary care providers, specialists, and the interdisciplinary team to align care plans with patient-centered goals, effectively communicates care objectives, and promotes adherence to the plan of care to improve health outcomes. Maintains accurate and timely documentation of care plans and patient interactions within the electronic health record in accordance with Riverside Health policies and procedures. Monitors and evaluates patient progress, adherence to treatment plans, and timeliness of follow-up, identifying variances, trends, and opportunities for improvement. Participate in data collection and program evaluation activities to support quality outcomes and continuous improvement. Adheres to established dementia care program protocols and workflows by completing required assessments accurately and within defined timeframes, ensuring compliance with care standards and supporting effective, consistent delivery of specialized dementia-focused care. Serves as a community resource by supporting outreach and engagement efforts, providing education on available services, and fostering connections between patients, caregivers, and community-based resources to enhance access to care and promote overall health and well-being. Qualifications Education Bachelors Degree, Social Work, Gerontology, or a health-related field (Required) or Masters Degree, Social Work, Gerontology, or a health-related field (Preferred) Experience 5-6 years Demonstrated experience supporting individuals with memory loss and working collaboratively with their families. (Required) Licenses and Certifications CPR/BLS Certification - American Heart Association/American Red Cross/American Safety and Health Institute (AHA/ARC) within 30 Days(Required) Certified Dementia Practitioner (CDP) - National Council of Certified Dementia Practitioners (NCCDP) (Preferred) PAC Certified Dementia Champion (PAC-DC/L) (Preferred) Drives personal vehicle for RHS business 25% or more of the time to perform essential functions of the job Valid Drivers License Required Other Requirements Call Rotation To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers. If loving your work is important to you, consider a career at Riverside. By joining our team, you can make a difference in people's lives. Our mission is to care for others as we would care for those we love. We extend that sense of caring to every patient, resident and customer, as well as to each member of our team. We offer care at all stages of life, in hundreds of locations, giving you room to grow your career, along with great benefits and perks. At Riverside Health, your trust and safety are our top priorities. Unfortunately, job scams are on the rise across the country, and we want to help you feel confident in knowing what is — and is not — part of our hiring process. Learn more about how to recognize a legitimate Riverside job opportunity and what to do if you suspect a scam by visiting this site.