Care Navigator GUIDE (Guiding an Improved Dementia Experience)

MedStar Health is looking for a Care Navigator GUIDE MHCP to join our team at Montgomery Medical Center!

The GUIDE Care Navigator is a core member of the GUIDE team responsible for supporting patients with Dementia, families and caregivers as they navigate the healthcare system, providing information, resources and service coordination. The Navigator is a trusted resource for GUIDE patients, families, caregivers, and the care team to ensure seamless transitions of care, access to necessary services, and enhanced health outcomes. This position requires initiative to create, manage and adjust the patient/caregiver plan of care, escalate conditions that may impact avoidable utilization and improve the patient/caregiver experience.

MedStar Health is a great place to work and grow your career. We provide a supportive and inclusive work environment, comprehensive health and wellness benefits, generous PTO, tuition assistance, retirement plans, and many other benefits focused on your wellbeing. Apply today and learn how MedStar Health can be your next great career move!

Primary Duties:

• Patient Advocacy & Education: Serves as liaison between patients, families, caregivers, healthcare providers, and community agencies to ensure care needs are met. Provides clear, easy-to-understand education on treatment plans, care options, insurance benefits, and available resources to support informed decision-making.

• Care Coordination & Navigation: Assists with scheduling appointments, arranging transportation, securing home health/DME services, and resolving barriers to care. Supports onboarding, referrals, authorizations, and connects patients with appropriate healthcare and community resources.

• Care Management & Collaboration: Conducts ongoing outreach, including in-home visits and monthly follow-ups, to monitor care plan adherence, medication compliance, and completion of tests/procedures. Communicates progress and barriers to the Care Manager and escalates urgent clinical concerns as needed.

• Operational & Interdisciplinary Support: Manages high-volume patient support activities, ensuring timely responses to providers, care teams, and families. Participates in interdisciplinary meetings to coordinate care and support seamless service delivery.

• Documentation, Compliance & Continuous Improvement: Maintains accurate EMR documentation to meet regulatory standards. Supports quality improvement initiatives, stays current on GUIDE program requirements and evidence-based practices, and completes required education and certifications.

Qualifications:

• High School or GED (Required)

• Bachelor's degree in social work (Preferred)

• 1-2 years Experience working in a medical office, ambulatory practice setting, and or home health (Required)

• 1-2 years Experience working as a Care Navigator, and working with populations (geriatrics) with chronic disease, and or patients with Dementia (Preferred)

• Certified Medical Assistant (CMA)- (Preferred)

• Certified Nursing Assistant (CNA)- (Preferred)

• LPN- Licensed Practical Nurse State Licensure (Preferred)

• Cert Community Health Worker- CCHWMD (Preferred)

• Certified Medical Assistant (CMA)-AAMA (Preferred)

• CHHA- Certified Home Health Aide (Preferred)

• LCSW- Licensed Clinical Social Worker (Preferred)