Community Health Worker

Mosaic is looking for a compassionate Community Health Worker to serve as a bridge between patients and the care and social services they need. You'll work alongside a clinical team in both clinic and community settings — helping patients navigate systems, remove barriers, and take steps toward better health. Traditional Health Worker (THW) certification required — or willingness to obtain upon hire. This role is a great fit for someone who is self-directed, people-focused, and comfortable working without all the answers in hand.

Responsibilities

Patient Support & Case Management

• Build relationships and engage patients and their families of all ages, cultures, and demographics with positivity, care, and respect while setting and maintaining professional boundaries.
• Work independently and as a member of a team, collaborating with other Community Health Workers, nursing staff, medical and dental providers, and community partners.
• Assist patients and care team members in the development of care plans and patient goal setting.
• Screen patients for social determinants of health (barriers) and connect patients to available health and social services resources to help them achieve health and wellness goals.
• Stay well informed of available clinic and community-based resources, services, and programs, including eligibility requirements.
• Assist patients in navigating the health and social services system by:
  • Educating patients about services, eligibility criteria, and enrollment processes.
  • Providing scheduling and appointment coordination assistance.
  • Teaching skills and strategies to obtain care and self-advocate effectively, including helping patients overcome resistance to using available resources or services.
  • Completing or reviewing paperwork necessary for service acquisition and financial assistance.
• Review assigned patient lists and contact patients to facilitate access to resources and services.
• Seek solutions and services tailored to the needs of each patient.
• Facilitate continuity of care across the health and social services system by following up with patients to ensure needs were met, providing additional support, facilitating communication, or coordinating service delivery to avoid duplication of services.
• Deliver patient care within HRSA services scope and approved locations, including patient homes, community-based sites, and providing home-based care when necessary, adhering to defined services and safety protocols. Local travel required.
• Document in the electronic health record and other systems as required to fulfill expectations of documentation, coordination, and measurement.

Community Outreach

• Build and maintain positive working relationships with healthcare entities, social service agencies, and community-based organizations while representing Mosaic in and out of clinic.
• Notify leadership of opportunities for community partnership or collaboration to benefit patient needs.
• Attend and engage in community-based events as assigned; events are sometimes scheduled outside of usual working hours.
• Attend community meetings as assigned.

Patient Education

• Train and lead patient education opportunities (e.g., Walk with Ease, Living Well Series) as determined by program and patient needs.
• Schedule, recruit for, organize, and prepare for teaching or assisting with patient education opportunities and classes as assigned.
• Teach basic concepts of health promotion and disease prevention as directed by the nursing team.
• Provide support and encouragement to patients managing chronic illness as directed by the nursing team.

Requirements

• Traditional Health Worker (THW) certification required — or willingness to obtain upon hire.
• Excellent communication and interpersonal skills.
• Strong, proven computer proficiency.
• Knowledge of community social service agencies and programs.
• Fluency in Spanish preferred.

About Us

Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to healthcare. Since our founding in 2002, we have proudly served insured and uninsured patients regardless of age, ethnicity, or income. We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way.

At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team-based environment. Mosaic Community Health offers more than just a job — it is a lifestyle. A lifestyle of serving others, being an integral part of your community, and enjoying work/life balance. Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river!

Benefits

We offer a great benefit package!