Community Health Worker II

Baystate Health•Springfield, MA

8d•$19 - $34

About The Position

Summary: The Community Health Worker III (CHW III) takes a lead role in proactively helping patients and their families navigate and access health and community services while adopting healthy behaviors. The CHW III works as a member of the care team through an integrated approach to care management and community outreach. The CHW III works to promote, maintain, and improve the health of patients and their families by providing social support and informal counseling. The CHW III partners closely with different providers, patients, and outside organizations and is responsible for facilitating communication between patient and care teams across the care continuum and providing culturally appropriate health education and self-management support. Additionally, the CHW III will collaborate within a team-based care delivery model to improve the health and lives of our community members. The CHW III will participate in the development and implementation of innovative, cost-effective, and quality improvement delivery system changes that proactively meet the complex needs of our patients, including efforts to manage their behavioral and social needs in addition to their medical care. The CHW III engages in reporting required public health outcomes information as required by state and federal guidelines. The CHW III mentors and precepts CHW I or II to provide guidance as they grow into their positions. The CHW III is active with local community organizations, committees, and educational entities to expand knowledge, best practices, and improvements to the care of patients; serving as a seasoned liaison between patients and community agencies.

Requirements

CHW certification required
3 years of experience working as a Community Health Worker with above average work ethic
Trust, respect, and dignity for all human beings are core values among CHWs, and are central to efforts to address clinical and community integration and the social determinants of health
Ability to use a computer, Microsoft Office, EMR, and proficient in accessing and searching the internet
Ability to work and manage community care partner meetings and demands by being a liaison for the patient and health center
Strong communication and writing skills
Excellent time management and organizational skills
Willingness to work some weekend/evening hours depending on project and community needs, such as advocacy and community capacity building activities
Demonstrated ability to work as an effective team member in a complex and fast-paced environment
Excellent interpersonal skills and demonstrated ability to interact professionally with culturally and educationally diverse staff and clients
Must have the ability to work with highly sensitive and confidential information
Reliable transportation with MA driver's license
GED or HiSET

Nice To Haves

Bilingual skills are preferred and specific to the patient population being served.

Responsibilities

Target and outreach, including home visits, to the most vulnerable and at-risk patients and establish positive and supportive relationships
Proactively assist with medication adherence, reminding patients about upcoming appointments, arranging transportation assistance, and other services patients may need
Act as the primary contact person within the clinic for enrollment of new members and educate patients on all aspects of the healthcare delivery system
Complete Care Needs Screenings and all other applicable screenings to assess needs of the patient and provide appropriate referrals.
Seasoned in c oach ing patients in the effective management of their chronic conditions and establish healthy habits specific to their care plan to improve self-care continually.
Provides basic health education in individual or group sessions and helps patients to develop health management plans that support the achievement of their individualized health and wellness goals
Help patients identify and utilize community resources using databases, in addition to scheduling and accompanying them to appointments and assisting with the completion of applications for programs for which they may be eligible.
Facilitate communication and coordinate services between providers; work collaboratively and effectively within a multidisciplinary team
Builds and maintains positive working relationships with the clients, providers, supervisors, and all staff
Continuously expand knowledge and understanding of community resources and services, public health prevention, and evidence-based intervention programs provided
Seasoned in e ffectively work ing with people from diverse backgrounds, including translators, in reducing cultural and socio-economic barriers between clients and institutions.
Develops and implements culturally and linguistically tailored educational and support activities
Collaborates with the care team to track, monitor, and report on specified disease-related and patient-tracking measures
Documents activities, service plans, and results in inappropriate data collection tools and/or EMR in a clear and concise manner. Escalates concerns to healthcare team
Takes lead on coordinating, training, and mentoring of new CHW's
Reports out required Public Health outcome information as required by state and federal guidelines.
Collaborates with local community organizations, committees, and educational entities to improve the knowledge and best practices for the community and CHW team
Participates and/or presents relative topics to peers in quality meetings , staff meetings, or educational events. Assists and supports the role of the Care Coordinator.
Serves as role model and mentor to CHW I and II positions. Share educational knowledge and experience as needed .