ED Navigator - NSPG Care Management Program

Peabody, MA | Social Services/Mental Health - Other


North Shore Medical Center is embarking on new innovative programming within the Emergency Department (ED) to improve coordination and continuity of care. The goal of the ED Navigator role is to connect patients who present in the ED with internal and external programs and services that will promote better health outcomes. The ED Navigator will engage specific cohorts of patients, create a trusting relationship, navigate patients to appropriate resources, and make follow-up phone calls. Specifically, the ED Navigator will connect patients to existing care management programs or primary care (establishing new primary care when needed), providing follow-up when appropriate. The ED Navigator will also identify patients, screen them for social determinants needs (e.g. food insecurity, violence/safety, transportation, housing, etc.), connect patients to appropriate programming and community partners, and work with a community health worker to provide outreach if necessary. The role will prioritize serving Medicaid patients.


- Connect with patients to complete an initial assessment, provide referral to internal and external services and programs with a focus on primary care and social determinants of health gaps, and develop a follow-up a plan as appropriate.
- Manage follow-up with appropriate patients and provide continued connections to care systems and organizations, in a persistent manner for patients that are difficult to engage.
- Collaborate with supervisor to optimize role both within the ED and in collaboration with other North Shore Health System clinics and with community programs, as appropriate.
- Document each patient encounter using appropriate electronic tools. Track benchmarks of progress in care - including short term goal completion.
- Collaborate, advocate, and communicate with internal departmental resources and programs to link patients to appropriate services and ensure continuity of care.
- Provide advocacy and support in accessing hospital and community-based programs.
- Collaborate with care management team and/or community health worker to provide necessary outreach, if already enrolled, to ensure patient needs have been identified and addressed.
- Provide culturally competent care to patients from multiple ethnic and cultural backgrounds utilizing interpreter services, when needed.
- Coach and motivate patients, utilizing behavioral interviewing techniques, to identify and address barriers to accessing referred services.
- Assess efficacy of systems in order to optimize and scale this role over time.



- Minimum of 1 year experience working in a hospital, health center, or other health care setting

- Experience working with surrounding community organizations
- Experience working in a fast-paced ED or Urgent Care setting
- Bilingual (preferably Spanish/English) and bicultural

BS/BA in Social Work/Public Health or related field

Applicants with relevant experience will be considered. North Shore Medical Center is an affirmative action/equal opportunity employer. Minorities and women are strongly encouraged to apply. Pre-employment drug screening is required.

Why North Shore Physicians Group?

You’ll practice at the leading edge of patient-focused medicine in one of New England’s most scenic and historic locations. And you’ll make a difference every single day. Make your move to NSPG. We’re one team, with one focus. Join us.

With NSPG you’ll experience:

Excellent quality of life

The North Shore area offers:

  • Communities with varied and rich histories and convenient access to museums, art, restaurants and shops.
  • Natural beauty, handsome architecture and vivid history — only 15 miles north of Boston.
  • 30 miles of gorgeous rocky coastline with breathtaking beaches and harbors.
  • World-class sailing and close proximity to the mountains and picturesque New England.
  • Easy access to a multitude of universities, colleges, and public and private schools.

Clinical excellence

  • Our practices are certified Level 3 NCQA Patient-Centered Medical Homes.
  • For the fifth year in a row, North Shore Medical Center has been ranked a top regional hospital in Boston and Massachusetts by U.S. News & World Report.
  • Our affiliate, Massachusetts General Hospital, is one of U.S. News & World Report’s top three Honor Roll hospitals in America.
  • NSPG and NSMC use the Epic EMR that integrates patient care through the Partners HealthCare System, including Massachusetts General Hospital and Brigham and Women’s Hospital.

Career advancement

  • Grow, learn and develop new practice innovations.
  • Continue your medical education.
  • Make academic connections and explore teaching opportunities.
  • Explore leadership opportunities.
  • Develop clinical and administrative career ladders.

A supportive practice environment

  • Collaborative professionals.
  • Patient-centered care model.
  • Leadership that listens and values your contributions and ideas.
  • Autonomy and respect for your skills and expertise.
  • Excellent salary and benefits.


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