Job title

Community Health Worker (CHW)

Reports to

Director of Patient Experience

Status

 Non-Exempt (hourly)

Job purpose

The Community Health Worker (CHW) collaborates with an integrated medical team and community-based social services agencies to provide short term care coordination and connection to resources at Heartland. This position will support clients to improve their health and general well-being through education and provision of coordination of care and services. Works in both clinical and community-based settings, May act as a peer support worker, where applicable.

Duties and responsibilities

• Assists clients in the community or clinic setting. Communicates to patients the purposes of the program and the impact it may have on their wellbeing. Helps patients identify socio-economic issues that affect their overall health and develop health/social management plans and goals.
• Documents all patient encounters and contracts made on behalf of patients; completes and submits monthly reports; maintains comprehensive electronic client files, which include patient notes, release of information, assessments and other medical documents acquired on behalf of the patient. Documents activities, service plans, and outcomes achieved by client in an effective manner.
• Educates patients on the proper use of the Emergency Room and provides information for alternatives. Coaches’ patients in effective management of their chronic health conditions and self-care. Assists patient in understanding care plans and instructions. Motivates patients to be active and engaged participants in their health and overall wellbeing.
• Assists patients in accessing health related services, including but not limited to obtaining a medical home, providing instruction on appropriate use of the medical home, overcoming barriers to obtaining needed medical care and /or social services.
• Provides support and advocacy during initial medical visit or when necessary to assure patients' medical needs and referrals required are being conveyed. Follows up with both patients and providers regarding health/social services plans.
• Facilitates communication and coordinate services between providers and the patients. Coordinates and monitors services, including comprehensive tracking of patients' compliance in relation to care plan objectives.
• Educates individuals and communities about how to use health and social services systems
• (including understanding how systems operate).
• Participates in care coordination of services, provides referrals and follow-up.
• Facilitates social determinants of health services and address barriers to resources. • Facilitates communication and coordination of services between community partners, HHS providers and clinical team.
• Complies with CHW certified training, and successfully completes all applicable federal and state enrollment training required to carry out assistance to individuals and families. Continues training with CHW peers and CHW groups.
• May travel to designated counties, community locations, and various locations to perform outreach as required.
• Works in consultation with clinical teams, direct clinical support staff, and indirect clinical support staff to develop and implement policies and procedures that maximize patient-centered communication and services.

Qualifications

• High school diploma or GED; at least 1 year of experience directly related to the duties and responsibilities specified.
• Bi-lingual in Spanish and English preferred, but not required.
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Knowledge of community agencies and resources.
• Working knowledge of multi-system outreach programs related to health care delivery, clinical education, and health-related services.
• Ability to plan, implement, and evaluate individual patient care plans.
• Ability to communicate medical information to health care professionals and care coordinators over the telephone.
• Skill in organizing resources and establishing priorities.
• Creative and analytical thinking.
• High school diploma or equivalent. • Bi-lingual in Spanish and English preferred, but not required. • Community Health Worker (CHW) certification, required or obtainable within 6 months of employment.
• Minimum 2 years of experience in healthcare coverage and community resources.
• Ability to effectively communicate within and across departments and community at large.
• Ability to comply with applicable federal and state training requirements.
• Own vehicle, valid driver’s license, and auto insurance.

Working conditions

• This role requires movement throughout the building day or multiple locations during the day.
• This role may be exposed to infections and contagious diseases.
• This role is subject to interruptions.
• This role requires management of personnel and procedures in a high stress & high paced environment.
• This role completes tasks that are performed in close physical proximity to other people.
• This role requires working indoors in environmentally controlled conditions.

Physical requirements

• Moves equipment weighing up to 50 pounds.
• Moves throughout the building to meet with employees, patients, or visitors.
• Must be able to remain in a stationary position during shift.
• Ability to read, write, and speak English.
• Frequent communication with patients about their experience at the health center. Must be able to exchange accurate information in these situations.
• Operate a computer and other office equipment, such as tablets, scanners, printers, and phones.
• Adhere to process protocol or procedures.
• COVID vaccine required

Details

• Schedule: Full-time exempt.
  • Hours Mon-Friday 8:00AM-5:00PM (average 40 hours/week)
• Location: All Heartland Community Health Center Locations
  • Schedule may be altered by supervisor(s) as needed to allow for completion of expected duties of the position.