Barnstable and Surrounding Area)

CareSource•Massachusetts Mobile, MA

3d•$54,500 - $87,300•Remote

About The Position

The Community Health Worker - Massachusetts functions as a resource to enrollees on clinical care, health systems, and social drivers of health, supporting a panel of enrollees to overcome barriers to care and engagement related to social needs. This role utilizes evidence-based practices, key knowledge of community-based resources, recovery-informed principles, and coaching skills to improve member outcomes by impacting care access and utilization, closing care quality gaps, and optimizing member connection to medical, behavioral health, and substance use disorder resources.

Requirements

High School or GED diploma required
Two (2) years of experience in community or outreach settings working with clients who have complex needs, including medical, social, behavioral health, or substance use required
Must have valid driver's license, vehicle and verifiable insurance.
Employment in this position is conditional pending successful clearance of a driver’s license record check.
Influenza vaccination is a requirement of this position.
Annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment.
Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need

Nice To Haves

Associates degree preferred
Four (4) years of experience in health plan or managed care settings preferred
Bilingual preferred (Spanish, Vietnamese, Haitian Creole, Cape Verdean Creole, Portuguese)

Responsibilities

Review SDOH assessments and follow up based on enrollees' needs, goals, and preferences by participating in care planning and goal-setting, providing appropriate resources, education and support in determining the most appropriate post-intervention disposition.
Conduct in-person, virtual (telehealth), or telephonic visits with enrollees as needed or as requested.
Support the creation of comprehensive and holistic plans of care and contribute to enrollee Care Plan goals pertaining to SDOH and social needs.
Ensure appropriate, comprehensive, and timely documentation of all contacts, outreaches, assessments, and interventions in the Centralized Enrollee Record (CER).
Identify gaps in care pertaining to SDOH that create barriers and result in unmet needs, identify areas of opportunity and defined resources, and collaborate with the Interdisciplinary Care Team to implement appropriate and timely interventions.
Provide health education in collaboration with an enrollee’s Interdisciplinary Care Team and Primary Care Provider (PCP) or specialty care providers (e.g., behavioral health clinician).
Participate in and contribute to team meetings as appropriate, provide consultation and expertise to colleagues, including other CHWs and members of the Interdisciplinary Care Team.
May participate in the onboarding of newly hired CHWs via shadow visits and “onboarding buddies.”
Support CHS Department programs and initiatives, including community engagement and development/education, and quality improvement initiatives.
Participate in committees and workgroups, as assigned.
Perform any other job related duties as requested.