Community Health Worker

This role serves as a liaison and mediator between members, providers, community centers, and the organization. The Community Health Worker works independently in the community, engaging members within a specific target population to provide basic health literacy, linkage to community resources, and assistance navigating the healthcare system. The goal is to improve health outcomes, close care gaps, and enhance overall wellness by connecting members to providers and community resources while developing partnerships with community centers and local organizations.

Responsibilities

• Initiate outreach efforts, including face-to-face interactions, related to targeted preventive health, maternity, care transitions, and chronic condition initiatives.
• Educate members on the importance of preventive health services, assess opportunities for care management intervention, and make appropriate referrals, including to the Behavioral Health Managed Care Organization (BHMCO) as needed.
• Contact members, providers, and community agencies to coordinate access to preventive health services.
• Develop rapport with members and community centers to establish supportive relationships that empower members to take an active role in their health and wellness.
• Assist members with completing a Health Risk Assessment, identifying and addressing healthcare barriers (e.g., knowledge deficits, transportation, financial constraints), scheduling appointments, and answering questions.
• Collaborate with human services providers such as Head Start Programs, WIC, community centers, and homeless shelters, as well as state agencies like Children and Youth Services (CYS) and juvenile probation, to identify and outreach to members in need of services.
• Understand the organization’s lines of business and member benefits to provide accurate and current information to members in the community.
• Contribute to the development and preparation of educational materials for members and providers.
• Conduct provider and community training on Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services and other special preventive health initiatives.
• Provide summaries and outcomes of training to management and peers.
• Participate in the development of effective, measurable, and innovative programs with a special emphasis on reaching at-risk members.
• Represent the company at community events, including those sponsored by community centers.
• Perform other duties as assigned or requested.

Requirements

• Minimum of 1 year of experience in a healthcare-related customer service or marketing environment demonstrating the ability to positively impact member engagement in condition and case management programs.
• Knowledge of principles and processes for providing customer service, including needs assessment and meeting quality standards.
• Ability to interact well with peers, supervisors, and customers, and work as a team member.
• Problem-solving skills: ability to solve problems independently and creatively, and be proactive, self-directed, assertive, and innovative in system planning.
• Ability to handle multiple tasks simultaneously and respond to customer issues promptly.
• Strong written and oral communication skills.
• Appreciation of cultural diversity and sensitivity toward the Medicaid population, with demonstrated expertise in cultural competency, including working with members with limited English proficiency.
• Awareness of issues members face related to healthcare, such as transportation, childcare, lack of knowledge about preventive health, distrust of the system, and other personal, social, or financial barriers.
• Patience and empathy when interacting with members and all internal/external customers.

Qualifications

• Minimum: High School Diploma or GED.
• Preferred: Basic medical terminology background, experience with the targeted community or population, or Community Health Worker experience.

Skills

• Customer service and needs assessment.
• Team collaboration and interpersonal skills.
• Independent and creative problem-solving.
• Multitasking and prompt response to customer issues.
• Cultural competency and sensitivity, particularly with Medicaid populations.
• Written and oral communication.

Schedule

• This is a remote-based role, but the territory for this position is Allegheny, Beaver, and Westmoreland Counties. The ideal candidate must live within this area.
• Travel requirement: 50% - 75%.
• Position type: Primarily on-the-road, working face-to-face with members in the community.

Physical Demands

• Lifting up to 10 pounds: Constantly.
• Lifting 10 to 25 pounds: Occasionally.
• Lifting 25 to 50 pounds: Never.

Pay

Pay Range Minimum: $20.72 per hour
Pay Range Maximum: $30.12 per hour

Base pay is determined by a variety of factors, including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. Geographic differentials may apply for certain locations.