Accountable Health Partners Community Health Worker

Forward Leading IPA•Syracuse, NY

22d•$26 - $26•Remote

About The Position

This position systematically identifies, assesses, refers, and monitors high-need individuals to ensure access to essential services. By building and maintaining key service connections, the Community Health Worker utilizes a screening tool to identify the health and social needs of Medicaid recipients. This role is pivotal in identifying individuals eligible for Enhanced Health-Related Social Needs (HRSN) Services, facilitating appropriate referrals and ensuring necessary linkages and support systems are in place. This position is grant-funded through March 2027.

Requirements

Minimum of High School Diploma or GED.
Equivalent experience in lieu of education may be considered.
Minimum of 1-3 years' human services experience.
Possess excellent verbal and written communication skills.
Exceptional customer service skills with commitment to helping others.
Ability to quickly adapt and be flexible in approach to job tasks and challenges and maintain emotional control under stress.
Excellent time management skills with exceptional attention to detail and the ability to multi-task and manage multiple priorities with competing deadlines.
Capability to work cooperatively with culturally diverse clients, staff, and community service providers.
Basic computer literacy, including the ability to use email, conduct online research, and create basic documents (MS Office Suite including Excel, Outlook and Word).
NYS motor vehicle license, safe driving record and availability of personal vehicle for work.

Responsibilities

Engages directly with individuals seeking assistance.
Administers the Health-Related Social Needs Screening Tool to identify needed areas of support.
Short Term involvement with no ongoing caseload.
Facilitate referrals to appropriate community resources and healthcare providers.
Collaborate with the Care Team to ensure timely follow-up and service linkage.
Use online referral systems and databases to track and manage client referrals.
Advocate on behalf of clients to access necessary services and address barriers to care.
Educate clients about available community resources and assist them in navigating healthcare and social service systems.
Accurately document screening results, referrals, and client interactions in electronic systems.
Maintain detailed and organized records in compliance with organizational policies and standards.
Work closely with the Care Team, including care coordinators and other healthcare professionals, to ensure holistic client care.
Participate in regular team meetings and contribute insights on client progress and community resources.
Engage with community organizations to strengthen service networks and improve referral pathways.
Represent the organization at community events and provide outreach to identify individuals in need of services.
Provide information to community partners on mental health and substance use issues and resources.
Build relationships with community organizations and service providers.
Conduct outreach to identify individuals in need of services.
Represent the organization at community events and stakeholder meetings.
Other duties as assigned