The Community Health Worker (CHW) position is a non-clinician role that works in collaboration with the primary care health team to support the multi-disciplinary team approach of patient care by providing comprehensive, coordinated Community Health Worker interventions. Key performance indicators (community outreach and education, completing Health Risk screenings, initiating new referrals to Care Management) and other organizational mandates as designated.

Community Health Workers may directly assist members in improving their ability to improve their health outcomes by going to members in their communities. They also help design and implement systems to ensure members have access, knowledge, resources, and support from the Care Team.

• Abide by department guidelines, company policies, and HIPAA regulations
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded
• Understand and uphold CCNC goals, objectives, and standards
• Participate in community population-based initiatives that identify members out of care, enhance retention in care, self-management, and compliance with CCNC Care Management goals.
• Participate in assigned community based activities, including outreach to potential new members and making a referral for healthcare and services.
• Receive and document all referrals from various sources into the Care Management documentation platform
• Verify eligibility and demographic information
• May complete Health Risk & Social Determinants of Health Screenings as needed
• Assist with administrative duties to the member as necessary
• Assist with referrals on behalf of the Care Management team
• Provide information for access and coordination of resources
• Assist member with care coordination and health care system navigation
• Provide culturally appropriate health education, social support and information
• Advocate for members
• Access multiple EHR’s to obtain and upload into the care management platform
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
• Notify supervisor promptly of any issues with carrying out any duties assigned
• Perform other duties that assist in keeping the operations organized and functional
• Attend Departmental and corporate meetings, local and regional trainings, or other events as required
• Travel using personal vehicle will be required within the region and/or the State

Qualifications

• High school diploma or GED required
• 2-4 years minimum experience in a human services or health care setting with demonstrated knowledge of or ability work and/or within a targeted community.
• 2- or 4-year degree in health-related field preferred
• Bilingual in English and Spanish preferred
• Maintain a U.S. valid driver’s license with current auto liability insurance

• Knowledge of and experience working in patient or clinical data systems
• Computer skills required including various office software and the internet; experience with MS Office software preferred
• Knowledge of state and federal benefits system
• Excellent communication skills – oral and written
• Proficient Motivational Interviewing skills, teach back method, and other patient engagement and retention techniques.
• Organizational and time management skills
• Sensitivity to diversity of cultures, language barriers, health literacy and educational levels
• Knowledge of medical terminology
• Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
• Able to shift strategy or approach in response to the demands of a situation

• The job environment is a hybrid-environment to include community settings, office, or home environment.
• “Hands-on” clinical treatment or counseling/psychotherapy is NOT permitted when performing duties for the organization

• Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur
• Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
• Must be able to utilize office equipment, computer, keyboard and phone with or without assistive devices
• Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
• Travel will be required within the region and/or the State