Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision:a community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together.
As a private, non-profit 501(C) (3) community health organization, we serve over 506,563 medical, dental, and behavioral health visits from more than 96,867 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.
Since 1969,our employees have been making this mission a reality.Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond.If this sounds like an organization you would like to be a part of, we would love to meet you.
The Community Health Worker (CHW) will work with Enhanced Care Management (ECM) patients to improve their whole health through outreach and engagement activities by helping patients navigate/access community services/resources and adopt healthy behaviors. This position will serve as an integral component of the Street Medicine program, engaging and enrolling individuals experiencing unsheltered homelessness into ECM. Additionally, this role will encounter and manage a shifting landscape to meet the ECM needs of the homeless and underserved populations. The CHW will split their time between providing ECM services to patients in the community and in the clinical setting(50/50 split).
Responsibilities

• Maintains situational awareness and ensures scene safety when providing services in the community
• Conducts community outreach and establishes trusting relationships with patients while providing general support and encouragement
• Manages and provides ongoing follow-ups to an assigned caseload of patients including:
  
  • Schedules patient appointments and encounter patients using EMR Registration program
  • Uses basic motivational interviewing and goal setting
  • Conducts phone calls, home or living environment visits, and visits to other settings where patients are located
  • Assists patients attend appointments through assessing and addressing access barriers
  • Provides referrals for services to community agencies as appropriate
  • Assists patients connect with transportation resources and provides appointment reminders, as needed
• Assists patients with completing applications and registration forms
• Conducts eligibility determination, enrollment, and follow up with uninsured patients
• Liaises between patients and community service agencies to ensure patient needs and rights are met, including collaborates with community providers to ensure continuity of care
• Assists patients in navigating the healthcare system by finding and following up by phone and in-person with eligible ECM patients
• Documents and shares patient barriers with ECM team and PCP to improve care and outcomes
• Utilizes evidence-based approaches when engaging with patients to increase their sense of control over their health, such as motivational interviewing to promote collaboration between patients and their medical/behavioral care team
• Communicates and delivers easy to read information about health and wellness to the community and provides information on ECM patient benefits and services
• Advocates on behalf of ECM patients in the home or their living environment to community and provider organizations
• Builds and maintains a positive working relationship with providers, including interactions within provider offices, phone, email, fax, and other approved communication methods
• Assists the ECM team and providers to understand the culture, norms, beliefs, and preferences about patients and their communities by representing the community's voice
• Helps create messages and materials that fit community culture and delivers messages to fit the culture of patients
• Works collaboratively within the ECM team to discuss responsibilities, task sharing, conflict resolution, and patient case reviews
• Collaborates on patient care issues with other ECM team patients
• Participates in weekly case reviews and consults with the patient's PCP before taking any clinical action
• Ensures documentation is accurate, helpful, and compliant with regulatory requirements and accreditation standards, including recording required documentation in eCW and managed care plans ECM portal within one day
• Participates in required staff meetings or other activities, as assigned

Qualifications
Education/Experience

• High school/GED required
• Valid BLS certification required upon hire
• Two years' healthcare, behavioral health, street medicine, or social services industry experience required
• Experience working with unsheltered homeless and/or personal lived homelessness experience preferred
• Experience working in outreach and customer service within the medical office and behavioral health environments with individuals who struggle with substance use disorder and mental health issues preferred
• Valid CA Driver's License and proof of auto insurance required
• Bilingual (English/Spanish) or (English/Arabic) preferred

Additional Qualifications(Knowledge, Skills and Abilities)

• Knowledgeable about and experience with numerous cultural issues, such as immigration, socioeconomic, LGBTQIA , seniors, etc.
• Knowledgeable about and experience with trauma-informed practices, mental health conditions and addictive disorders
• Ability to perform intermediate computer and data entry skills
• Ability to apply emotional and cultural intelligence to provide appropriate communication and patient care
• Ability to sufficiently engage patients in a variety of settings including phone, in person/homes, community streets/shelters, and/or healthcare settings
• Knowledgeable about the community-based resources, especially non-professional resources and their reputation in the community
• Ability to develop relationships with community patients and leaders, including faith-based community
• Ability to make decisions and sound judgements to anticipate the needs of patents and knowing when to consult with the team, supervisors, and experts
• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Ability to successfully manage multiple tasks simultaneously, including changing priorities and time sensitive deadlines
• Excellent planning and organizational ability
• Excellent teamwork and relationship building skills
• Ability to work as part of a team as well as independently
• Ability to work with highly confidential information in a professional and ethical manner

Physical Requirements

• Ability to lift/carry 20 lbs/weight
• Ability to stand for long periods of time

Pay Range: $25.05 - $29.71 per hour, depending on experience.