Community Health Worker (Pathways To Better Health Program)

Job Description

Under the direction of the Nurse Supervisor, serves as a bridge between underserved communities and available community resources using the Pathways to Better Health model. Assists clients in overcoming barriers to health, social services, education and employment through home visits. Acts as a liaison to primary care and hospital care providers by gathering client clinical data and sharing essential information to support coordinated care. Uses evaluations conducted by clinical professionals to assist clients and connect them with services.

This is a full-time, benefitted position based out of the Public Health Offices in Holland located at 12251 James St, Holland, MI 49424 with substantial travel in the community. Typical work hours are Monday - Friday, 8:00 am - 5:00 pm.

Essential Job Functions

The essential functions of this position include, but are not limited to, the following:

• Conducts client interviews to identify needs related to health, employment, housing, utilities, family dynamics, and physical or mental health, and completes required checklist.
• Gathers medical, psychological, and social information contributing to the client’s situation and provides this information to clinical professionals for evaluation.
• Determines client eligibility for services and assistance programs and makes appropriate referrals to community resources and partner agencies.
• Research, documents, and maintains information on client needs and available community resources.
• Performs timely and accurate documentation related to client interactions and resource coordination.
• Advocates for clients and serves as a liaison between clients, service providers, health systems, and community agencies.
• Facilitates individual or group discussions to help clients and families understand and follow medical and health care recommendations.
• Implements follow-up activities based on care plans and recommendations developed by clinical professionals.
• Successfully completes required training and curriculum required for position, including the Community Health Worker Certification and required continuing education.
• Follows departmental and Pathways to Better Health protocols for care coordination and service delivery.
• Performs other functions as assigned.

Required Education, Training and Experience

High school diploma or GED. Experience with social services or public health system is preferred. Knowledge of and experience with different cultural and ethnic groups within Ottawa County is strongly preferred. Bilingual (Spanish) written and verbal medical translation skills preferred. Lived experience with mental or physical illness, accessing safety-net services, and/or personal hardship are valued.

Additional Requirements and Information

REQUIRED KNOWLEDGE AND SKILLS:

• Strong interpersonal and customer service skills, with the ability to communicate effectively and engage individuals across diverse cultures, socioeconomic backgrounds, and age groups.
• Proficiency in computer applications, including electronic medical records, word processing, spreadsheets, and database management.
• Adheres to all regulatory requirements governing the confidentiality of patient health information, including the provisions under HIPAA.
• Knowledge of the cultural and ethnic groups represented in Ottawa County, including cultural norms that influence health maintenance and health care practices.
• Working knowledge of health care services and public and private human service resources available to client populations.
• Awareness of the Michigan Public Health Code, Michigan Department of Health and Human Services, Ottawa County Department of Public Health, and Medicaid regulations and standards.

• Must possess or have the ability to obtain Community Health Worker Certification.
• Must possess a valid driver's license.

• Ability to sit, stand, walk and access clients’ homes in various environments, bending over and lifting/holding/carrying objects found in an office environment.
• Ability to communicate and respond to co-worker and customer inquiries both in person and over the phone.
• Ability to handle varied and often high levels of stress.
• Frequent travel throughout the County is a necessary part of this role. Ability to travel throughout the County using your own vehicle. Must be able to drive. Mileage will be reimbursed according to County and IRS guidelines.

Job Description

Under the direction of the Nurse Supervisor, serves as a bridge between underserved communities and available community resources using the Pathways to Better Health model. Assists clients in overcoming barriers to health, social services, education and employment through home visits. Acts as a liaison to primary care and hospital care providers by gathering client clinical data and sharing essential information to support coordinated care. Uses evaluations conducted by clinical professionals to assist clients and connect them with services.

This is a full-time, benefitted position based out of the Public Health Offices in Holland located at 12251 James St, Holland, MI 49424 with substantial travel in the community. Typical work hours are Monday - Friday, 8:00 am - 5:00 pm.

Essential Job Functions

The essential functions of this position include, but are not limited to, the following:

• Conducts client interviews to identify needs related to health, employment, housing, utilities, family dynamics, and physical or mental health, and completes required checklist.
• Gathers medical, psychological, and social information contributing to the client’s situation and provides this information to clinical professionals for evaluation.
• Determines client eligibility for services and assistance programs and makes appropriate referrals to community resources and partner agencies.
• Research, documents, and maintains information on client needs and available community resources.
• Performs timely and accurate documentation related to client interactions and resource coordination.
• Advocates for clients and serves as a liaison between clients, service providers, health systems, and community agencies.
• Facilitates individual or group discussions to help clients and families understand and follow medical and health care recommendations.
• Implements follow-up activities based on care plans and recommendations developed by clinical professionals.
• Successfully completes required training and curriculum required for position, including the Community Health Worker Certification and required continuing education.
• Follows departmental and Pathways to Better Health protocols for care coordination and service delivery.
• Performs other functions as assigned.

Required Education, Training and Experience

High school diploma or GED. Experience with social services or public health system is preferred. Knowledge of and experience with different cultural and ethnic groups within Ottawa County is strongly preferred. Bilingual (Spanish) written and verbal medical translation skills preferred. Lived experience with mental or physical illness, accessing safety-net services, and/or personal hardship are valued.

Additional Requirements and Information

REQUIRED KNOWLEDGE AND SKILLS:

• Strong interpersonal and customer service skills, with the ability to communicate effectively and engage individuals across diverse cultures, socioeconomic backgrounds, and age groups.
• Proficiency in computer applications, including electronic medical records, word processing, spreadsheets, and database management.
• Adheres to all regulatory requirements governing the confidentiality of patient health information, including the provisions under HIPAA.
• Knowledge of the cultural and ethnic groups represented in Ottawa County, including cultural norms that influence health maintenance and health care practices.
• Working knowledge of health care services and public and private human service resources available to client populations.
• Awareness of the Michigan Public Health Code, Michigan Department of Health and Human Services, Ottawa County Department of Public Health, and Medicaid regulations and standards.

• Must possess or have the ability to obtain Community Health Worker Certification.
• Must possess a valid driver's license.

• Ability to sit, stand, walk and access clients’ homes in various environments, bending over and lifting/holding/carrying objects found in an office environment.
• Ability to communicate and respond to co-worker and customer inquiries both in person and over the phone.
• Ability to handle varied and often high levels of stress.
• Frequent travel throughout the County is a necessary part of this role. Ability to travel throughout the County using your own vehicle. Must be able to drive. Mileage will be reimbursed according to County and IRS guidelines.

This position is benefited and is in the AFSCME bargaining unit.

Ottawa County offers a wide range of benefits to support you in your career. View the Benefits Summary for more information.

The current wage scale can be viewed here.

**Part-time benefitted positions will recieve prorated benefits.