Community Health Worker
About the role
This position will be the primary care manager for members with complex medical or behavioral needs who aren't otherwise managed by the team's clinicians. The CHW works assertively to locate and engage members in the community. They will develop individualized plans of care that focus on the member's definition of success. The CHW identifies and overcome barriers to goal achievement, including SDOH barriers. This position will work in collaboration with the interdisciplinary clinical care management team (Pod) to advance interventions aligned with a member's readiness to change.
Responsibilities
- Partner with clinical care management team to manage complex members in the community
- Locate and engage members in the community
- Conduct screenings face to face or telephonically, to assess member medical, behavioral, functional, cognitive and psychosocial needs, i.e. health risk assessment
- Research, locate and make referrals to community resources to address member specific care or socioeconomic needs. Follow up to confirm services are received.
- Perform targeted activities and provide education to support HEDIS/STAR gap closure, including scheduling, reminding and verification of appointments to receive specific services
- Proactively engage the member to manage their care, provide education and coaching to support self-management of needs and health promotion as outlined in care plan
- Collaborate with internal care team, community partners and providers
- Consult with clinical team based on defined triggers
- Support identification of and coordination to support access of Medicaid benefits to support care needs
- Aid member in development of personal wellness plan / health crisis plan
Requirements
- High School Diploma/GED
- 3+ years of experience working within the Community Health setting in a healthcare role
- 2+ years of experience working within the local community, with intermediate level of knowledge of culture and values within the community and familiarity with the resources available within the community
- Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
- Intermediate experience with Microsoft applications
- Ability to travel 10% of time for role
Qualifications
- Bachelor's Degree (or higher) in Social Work or related subject
- Licensed Practical Nurse (LPN) or Certified Nursing Assistant (CNA) / Home Health Aide (HHAB)
- Bilingual in Spanish (preferred)
- Community Health Worker (CHW) Accreditation (preferred)
- Experience working in team-based care
- Experience working in Managed Care
- Lived experience (self or family) in managing or overcoming a chronic health, behavioral health or substance use condition
Skills
- Possess a strong work ethic
- Listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
- Adapt to change in the workplace
- Work independently and as a part of a team
- Interact with internal and external customers in a corporate environment
- Maintain a positive and motivated attitude
- Willingness to adapt to multiple external environments and settings
Benefits
- Competitive base pay
- Full and comprehensive benefit program
- Performance rewards
- Management team who demonstrates commitment to your success
- Local labor market, education, work experience, certifications, etc. determined pay range
Pay
The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Schedule
This position is a field-based position with a home-based office. You will work from home when not in the field. Locations will vary but within the following counties of Florida: Alachua, Bradford, Citrus, Miami Dade, Monroe, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union, Baker, Clay, Duval, Flager, Nassau, St Johns and Volusia. Local travel up to 10% and mileage is reimbursed at current government rate.