Community Health Worker Senior - Grant Programs

Description Summary: Conducts advanced outreach to the community. May coordinate charitable programs. Develops relationships with the community and community leaders. Responsibilities The Community Health Worker (CHW) provides culturally appropriate support and information for the patient and their families in a series of structured visits and follow-up phone calls in a variety of settings, including the patient’s homeKnowledge of resources in the community and refers patients to themAssists patients in their understanding of how to use healthcare and social services and manage their Patient Health Record (PHR)Has a holistic and interdisciplinary approach to care management and health promotionBuilds relationships with the patient, their families, healthcare providers, and the communityAssist patients in finding and understanding how to use a Medical Home (patient’s primary choice of physician or clinic), pharmacy assistance programs, dental services, diagnostic services, transportation, behavioral health services, and other services as neededRefer patients to healthcare and social services and follow up on all referralsFollow care pathways (evidence-based steps) designed and selected to deal with patients’ specific health and social concerns and problemsDocument activities through appropriate record keeping that follows the organization’s policies and proceduresMaintains patient registryConsult with the administrative supervisor and clinical supervisor to coordinate activities and schedule, and to address identified health care needs of the patientEducate patients and their families in healthy lifestyles and promote health behavior changeEncourage patient to set goals, identify barriers and challenges, and monitor their own conditions Requirements Bachelor's Degree preferred Work Schedule 5 Days - 8 Hours Work Type Full Time