Community Health Worker - Telephone Support

Hope Family Health•Westmoreland, TN

About The Position

The Community Health Worker (CHW) helps patients access and navigate HOPE Family Health services and community resources. This position is assigned to Medical Telephone Support and assists patients by phone with follow-up and coordination of medical services. The CHW communicates with patients and care teams, identifies barriers to care, coordinates follow-up, and accurately documents services. Depending on the assignment, the role may focus on medical or behavioral health telephone support, language access, referrals, outreach, care coordination, or connecting patients with resources such as food, housing, financial assistance, and transportation. Duties are limited to the CHW’s assigned area, training, credentials, and HOPE policies; individual CHWs are not expected to perform every duty listed. The role involves building respectful, trusting relationships with patients and families; communicating in a culturally responsive manner; contacting patients by telephone, electronic message, or in person as assigned; helping patients understand care information approved by the care team; identifying barriers and connecting patients with appropriate resources; coordinating with internal teams and external partners; and maintaining timely, accurate records while protecting confidential information. The CHW participates in team meetings, training, quality improvement, and updates to resource information and workflows. Additional duties depend on assignment and qualifications and may include telephone support, referral coordination, language access, records and care coordination, and community engagement. Clinical triage or assessment may be performed only by staff whose credentials, role, training, and HOPE authorization permit it. Off-site work is not required, but some tasks may be completed remotely with prior Team Leader approval and an appropriate confidential workspace. The position functions primarily in a professional office or clinical environment, with occasional travel between HOPE sites and possible occasional extended hours based on organizational needs.

Requirements

High school diploma or equivalent required.
Ability to communicate clearly and respectfully with patients, colleagues, and community partners.
Ability to organize competing tasks and use sound judgment about when to escalate concerns.
Ability to use electronic health records and standard office software, or learn them with training.
Must be able to communicate effectively in English, verbally and in writing.
Sufficient vision and hearing to perform duties and communicate by phone and in person.
Occasionally required to lift or move items up to 25 pounds.
Any clinical duties require applicable credentials and HOPE authorization.
Additional language proficiency, interpreter qualifications, professional credentials, and Basic Life Support certification may be required for specific assignments.

Nice To Haves

Relevant experience in health care, behavioral health, patient service, community outreach, or resource navigation.
Knowledge of local resources and barriers to care.
Fluency in a second language.

Responsibilities

Build respectful, trusting relationships with patients and families; communicate in a culturally responsive manner and support patient choice and self-advocacy.
Contact patients by telephone, electronic message, or in person as assigned; respond to questions, relay approved information, identify needs, and route clinical concerns promptly to appropriate licensed staff or providers.
Help patients understand appointments, care plans, referrals, tests, and next steps using information approved by the care team; reinforce education and instructions without independently diagnosing, treating, or giving clinical advice.
Identify barriers to care, including transportation, insurance, cost, language, food, housing, and access to services; connect patients with HOPE programs and community resources and follow up as assigned.
Coordinate with medical, behavioral health, pharmacy, and other teams and external partners to support continuity of care and timely follow-up.
Maintain timely, accurate records of contacts, referrals, services, and follow-up in the electronic health record and other approved systems; protect confidential information.
Participate in team meetings, training, quality improvement activities, and updates to resource information and workflows.
When assigned, manage incoming and outgoing patient communications, route messages, relay provider-directed results or instructions, and support medical or behavioral health workflows.
When assigned, track referrals, gather and transmit information through approved channels, obtain required authorizations, coordinate specialty appointments, inform patients of status and next steps, and follow up on completion.
When qualified and authorized, provide bilingual navigation and interpret spoken communication or translate written material under HOPE policy; arrange qualified language assistance when needed.
When assigned, process records and correspondence, obtain or document appropriate releases, support discharge follow-up and external service coordination, and respond to authorized information requests.
When assigned, participate in outreach, health fairs, patient education, resource navigation, and other community-based activities.
Perform other duties as assigned by the Team Leader to support departmental operations and organizational needs.