Community Health Advocate Lead

About the role

Department: MGB Diabetes Initiative

The Community Wellness Advocate (CWA) Lead will provide day-to-day leadership and operational support for the HEART CWA + Outreach team, serving clinically and socially complex patients enrolled in the HEART of Communities program. As such, the CWA Lead will uplift and promote the efficacy and efficiency of HEART in its mission to improve control of hypertension and diabetes while addressing social and structural factors that disproportionately impact the health and economic status of HEART eligible populations. The CWA Lead will combine direct patient-centered navigation with team leadership, oversight, workflow coordination, and workflow integration. This individual will serve as a key link between the CWA team, the Operations Manager, and the broader HEART leadership team. In doing so, the CWA Lead will help ensure that navigation core competencies including resource allocation, psycho-social, goal-setting, and motivational interviewing are consistent, responsive, well-documented, and aligned with HEART program goals.

Responsibilities

• Team Support: Lead a team of CWAs providing onboarding, training, education, and hands on support for complex cases, leads team and individual meetings, and supports the Operations Manager with CWA workflow development and implementation
• Panel Management: Manage and support a panel of patients navigating diabetes and hypertension care enrolled in the HEART program through proactive outreach, relationship building, assessment of social, financial, and clinical barriers, remote monitoring support, and ongoing follow-up in collaboration with the care team.
• Care Coordination & System Navigation: Coordinate referrals to community resources, assist with benefits and service applications, support health care and resource navigation, address barriers to care, and promote patient self-advocacy and engagement in accessing clinical care and social services.
• Education & Coaching: Collaborate with the patient and the care team to identify clinical goals and address health related social needs. Provide culturally responsive health education, self-management support, and coaching, and reinforcement to promote healthy behaviors and empower patients to achieve their care goals.
• Documentation & Case Presentation: Document assessments, patient interactions, barriers to care, interventions, and care plans accurately and timely. Communicate key patient updates and recommendations succinctly during team huddles and care reviews.

Requirements

• Bachelor’s degree and at least three years of working with patients in a healthcare setting; or equivalent combination of education and experience.
• Community Health Worker Certification (within 6 months of hire)

Skills

• Strong oral and written communication, interpersonal, organizational, and record-keeping skills.
• Proficiency with software applications, including Microsoft Office and electronic medical record systems

Pay

Compensation range: $53,000.00 - $77,000.00 annually. This range offers an estimate based on the minimum job qualifications. Base pay is determined comprehensively, considering education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. Range is based on Boston-area data and subject to modification based on geographic location.

Benefits

• Medical, dental, vision, and pharmacy benefits
• Discretionary annual bonuses and merit increases
• Flexible Spending Accounts
• 403(b) savings matches
• Paid time off
• Career advancement opportunities
• Resources to support employee and family well-being

Schedule

Full Time