CBCM Health Navigator

Allegheny County Housing Authority•McKees Rocks, PA

3h•Hybrid

About The Position

This is a full-time, grant-funded 35-hour/week position focused on delivering targeted Health Care Case Management. The role addresses all domains of social determinants of health, providing direct services to residents in public housing sites within Allegheny County. The goal is to support individuals toward self-sufficiency, housing stabilization, and reduced risk of adverse health outcomes.

Requirements

Bachelor’s Degree in Social Work, Psychology, Nursing, OR no degree and minimum of 4 years of demonstrated relevant experience
Obtain Advanced First Aide and CPR certification within 6 months of employment
Must have and maintain a valid PA driver’s license and use of a personal vehicle

Nice To Haves

Compiling and sorting date, entering raw date into database
Proficient in various programs to include, but not limited to: Microsoft Outlook, Word, and Excel
Demonstrated knowledge and experience in the provision of community social services, insurance benefit navigation and continuum services of care

Responsibilities

Must be able to work independently, moving ACHA residents in the direction of independence by encouraging self-determination, and self-evaluation and consistently assisting ACHA residents to recognize their own strengths and using those strengths for personal growth
Must demonstrate a strong work ethic and a high level of integrity
Provide direct services to recipients within ACHA for the purpose of outreach, intake and assessment, education, and/or referral for identified Social Determinants of Health (SDOH) needs
Maintain an active caseload of at least 40 individuals within the ACHA portfolio
Must maintain confidentiality and provide information within agency guidelines and on a need-to-know basis
Provide services in an empathic, hopeful, and welcoming manner
Complete all documentation and data collection in accordance to State and agency requirements including intake, assessments, data entry, and progress notes
Prepare and maintain all necessary documents for the case file and insurance provider reporting
Provide education and linkage to Medical Assistance providers and support the development of living skills that will improve health outcomes
Enhance coordination of services for behavioral and physical health with local Medicaid insurance providers
Engage Community-Based Organizations as part of an integrated holistic approach to person-centered care and education
Work collaboratively with the CBCM Associate Director to identify interventions and resources available that increase Health literacy and reduce the risk of utilization of acute services
Develop and maintain a comprehensive list of local and state resources that address each domain of Social Determinants of Health, with a focus on street medicine, harm reduction and preventative screening best practices
Foster Cross-Departmental collaboration to help identify community-level needs and produce outcome deliverables
Ability to demonstrate time management, team collaboration, and professional written and verbal communication skills
Ability to demonstrate critical thinking and problem-solving to determine the best plan for each individual on their caseload
Provide quarterly and annual follow-up to ensure individuals served were satisfied with services and have maintained the resources provided
Communicate with other team members and program manager about resident progress and needs
Participate in scheduled supervisions to provide and accept feedback and identify opportunities for continued professional development
Develop individualized treatment plans with each resident to further develop their ability to live independently in the community
Obtain Advanced First Aide and CPR certification within 6 months of employment
Must have and maintain a valid PA driver’s license and use of a personal vehicle