Community Health Worker

CVS Health

22h•Remote

About The Position

At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Aetna Better Health of West Virginia (ABHWV) plan has a successful, 26+ year history of partnering with the State to provide West Virginia’s Medicaid population with top notch health care coordination and service. The plan also has been chosen to provide care coordination to complex foster care children of the state. Through a strong, localized team, an innovative care management model, and creative provider and community advocacy partnerships, ABHWV has successfully assisted the State in achieving high quality standards and outcomes for the Medicaid population across the state. The health plan truly embodies the commitment of West Virginians helping West Virginians. At ABHWV, as a Community Health Worker (CHW) you will join strong teams committed to helping our members and with opportunities for career growth. The Community Health Worker (CHW) role is a full-time field teleworker position that requires West Virginia residency. Travel with personal vehicle is required 70% of the time or more in the central, south, and west regions of the state, and mileage is reimbursed per company expense reimbursement policy. Field-based travel locations may include but are not limited to member homes, residential treatment facilities, shelters, group homes, and community settings. Qualified candidates must reside in one of the following counties: Kanawha, Putnam, Jackson, Lincoln, Roane, Clay, Nicholas, Fayette, Boone, or Raleigh. The CHW position is part of our care management team, responsible for telephonic and/or face-to-face member contact to assess needs and provide support. This role is heavily community-based with opportunities to serve as a bridge between the member, community, and the healthcare system. CHWs address any gaps in care by connecting members with providers and community resources or services to overcome barriers to their well-being. Through outreach, education, and advocacy, they promote better health outcomes and coordination of care. CHWs of ABHWV work with all ages in our Medicaid population, which includes youth in our Children’s Specialty program. This program includes foster and child welfare youth and families, along with adopted members, Children with Special Health Care Needs (CSHCN), Children with Serious Emotional Disturbances (CSED) waiver recipients, and youth involved with the Department of Juvenile Justice.

Requirements

High School Diploma /G.E.D. or higher
2+ years relevant experience (i.e. healthcare, community-based, social services, case management, etc.)
Complete an approved CHW certification program within 12 months of hire.
Demonstrated proficiency with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).
Must possess reliable transportation, valid/active driver’s license, and proof of vehicle insurance with ability to travel up to 70% of the time to various locations within the region using personal vehicle. Mileage is reimbursed per company expense reimbursement policy.

Nice To Haves

Experience in community/outpatient setting preferred.
Experience in serving the Medicaid Populations in urban or rural environments with knowledge of local formal and informal resource networks preferred.
Community Health Worker Certification or equivalent training and experience preferred.
Motivational Interviewing skills.
Experience with complex children/adolescent populations (to include but not limited to: complex physical health, adoption, juvenile justice and foster care experience), the delivery of behavioral health services, and evidence-based practice preferred.
Experience with high-risk, chronic physical and/or behavioral health conditions and interventions (such as experience working in a clinic, provider office, hospital, etc.)

Responsibilities

Conduct home visits with Aetna members to assist with needs, including but not limited to locating community resources, scheduling appointments, completing applications for eligible programs, arranging transportation, and educating on services, medications, conditions, etc.
Complete telephonic and/or email outreach to members, agencies, care providers, community organizations, etc. regarding member needs and care
Collaborate with care team participants, including but not limited to care manager, department workers, legal or custodial guardians if applicable, healthcare providers, community partners, etc.
Assess any gaps in care or social determinants of health that may be impeding care or overall well-being and formulate interventions to address any identified areas of need
Connect with various community organizations and partners regarding resource availability and eligibility to support member needs
Demonstrate flexibility to work in situations where working conditions or environments are unknown, as member homes and situations may vary
Document all member outreach and care coordination in electronic health record system in accordance with market processes and maintain the member record to ensure compliance
Maintain member confidentiality and protected health information (PHI) according to HIPAA policies and company guidelines
Work independently to organize, problem-solve, and prioritize tasks to meet deliverables, deadlines, and expectations
Utilize strong interpersonal and communication skills that allow for work with individuals of diverse cultural and socioeconomic backgrounds
Travel extensively (70% of the time or more via personal vehicle) to member homes, community locations, various agencies, etc. as indicated
Other responsibilities as indicated