Health Care Navigator
Company: Rising Ground, Inc.
Location: New York City
Posted on: February 24, 2026
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Job Description:
Job Description Job Description About the role: Support Medicaid
Members to understand their rights, benefits and responsibilities
under Medicare, Medicaid and related managed care programs We are
seeking a compassionate, self-motivated and dedicated individual to
join our HealthCare Navigation team and lead the new services
associated with the Independent Consumer Advocacy Network (ICAN), a
program in New York State that helps people with Medicare,
Medicaid, and managed care plans to understand and exercise their
rights, navigate health insurance issues, and resolve problems with
their coverage and care Key Responsibilities Member Engagement: Ø
Educate members and their caregivers on the scope of their Managed
Long-term Care (MLTC) benefits, how to access services e.g., home
care, adult day health care, transportation, and their rights and
responsibilities. Ø Conduct initial and ongoing assessments of
members' needs, preferences, social determinants of health, and
understanding of their MLTC plan. Ø Act as a trusted point of
contact for member questions regarding enrollment, disenrollment,
and service authorization processes. Ø Promote health literacy and
self-advocacy skills among members. Care Coordination and Service
Access: Ø Coordinate referrals to a comprehensive network of
providers and community resources ensuring timely access to
necessary MLTC-covered services. Ø Troubleshoot and resolve
barriers to care, such as transportation issues, appointment
scheduling conflicts, or difficulties with authorization approvals.
Ø Act as a liaison between the member, providers, the MLTC plan,
and social services agencies. Administrative and Compliance: Ø
Maintain accurate and timely documentation of all member
interactions, service coordination efforts, and outcomes in
Salesforce. Ø Ensure all activities comply with federal and state
regulations, Medicaid MLTC guidelines, and organizational policies.
Ø Assist members with Medicaid recertification and other
administrative tasks critical to maintaining their MLTC
eligibility. Ø Maintain and submit necessary documentation and
reporting about services provided, outcomes, and performance
metrics Ø Participate in provider, funder and network meetings as
well as weekly HealthCare Navigation meetings Qualifications: Ø
Demonstrated experience working with Medicaid populations and
specifically individuals with disabilities who require long-term
services and supports. Ø Expert knowledge of the Medicaid MLTC
program Ø Strong organizational and problem-solving skills with an
ability to manage a demanding caseload. Ø Proficiency in utilizing
case management software and electronic health records. Ø Bilingual
skills (e.g., Spanish and English) is a significant asset,
depending on the service area. Ø Exceptional interpersonal,
communication (written and verbal), and active listening skills. Ø
Compassionate, empathetic and patient-centered with ability to
handle sensitive and maintain confidentiality Education: Ø
Associate’s or Bachelor’s degree preferred; Graduate degree in
Social Work, Public Health, Healthcare Administration, or a related
field is preferred Ø Minimum of two (2) years of experience in a
healthcare, managed care, or social service setting Equal
Employment Opportunity Statement It is the policy of Rising Ground
that the Agency wholly complies with equal treatment of all
employees and applicants for employment without unlawful
discrimination as to an individual’s perceived or actual race,
creed, color, national origin, alienate, citizenship status,
gender, age, disability, marital status, partnership status, sexual
orientation, ethnicity, religion, or veteran status in all
employment decisions, including but not limited to recruitment,
hiring, compensation, training and apprenticeship, promotion,
upgrading, demotion, downgrading, transfer, layoff and termination
and all other terms and conditions of employment.
Keywords: Rising Ground, Inc., Hartford , Health Care Navigator, Healthcare , New York City, Connecticut
