Community Health Worker

Lamoille Health Partners•Morrisville, VT

2d•$45,000 - $50,000

About The Position

Lamoille Health Partners is seeking a Community Health Worker to join its integrated care team. The role works directly with patients and families to identify health goals, overcome barriers to care, and develop practical plans for long-term well-being. As a link between patients, healthcare providers, and local resources, the Community Health Worker provides care coordination, transitional support, and community outreach to help improve access to compassionate care. The position uses a holistic, patient-centered approach to assess patients’ social, emotional, and financial needs; builds therapeutic relationships using motivational interviewing; and supports patients with self-management and personal health goals. It also provides brief mental health and substance use support, assists with post-hospital transitions, connects patients to programs and resources, and collaborates with multidisciplinary care teams and community partners. The role maintains documentation in the electronic medical record, supports staff education about underserved populations, and participates in quality improvement and accreditation activities.

Requirements

Bachelor’s degree in Human Development, Psychology, Public Health, Social Work, or a related field.
At least 2 years of experience working with chronic care needs.
Strong understanding of patient-centered engagement and motivational interviewing techniques.
Exceptional interpersonal, communication, and organizational skills.
Proficiency with electronic health records and office technology.
Ability to manage shifting priorities and work effectively under pressure while maintaining a compassionate approach.
Commitment to patient confidentiality and HIPAA compliance.

Nice To Haves

Experience working with chronic care needs in a primary care setting is ideal.

Responsibilities

Meet with patients on-site or in the community to assess social, emotional, and financial needs using a holistic, patient-centered approach.
Use motivational interviewing to build therapeutic relationships, develop self-management plans, and support patients in achieving personal health goals.
Provide brief mental health and substance use support and connect patients with behavioral health, MOUD, and peer recovery resources.
Assist patients after hospital discharge to support smooth transitions and improved health outcomes.
Help patients access low-cost medications, Sliding Fee assistance, health insurance enrollment through Vermont Health Connect, and transportation.
Build partnerships with local schools, human service agencies, and community organizations to expand access points for care.
Participate in multidisciplinary care teams and case reviews to deliver wrap-around support.
Maintain accurate, timely documentation in the Electronic Medical Record (EMR).
Advocate for and educate staff about the needs of underserved populations.
Participate in Patient-Centered Medical Home (PCMH) accreditation activities, quality improvement projects using PDSA models, and departmental initiatives.