Community Health Worker - Care Transitions & Navigation

Community HealthWorks • Sacramento, CA

2d • $25 - $31 • Onsite

About The Position

The Community Health Worker (CHW) – Care Transitions & Navigation helps individuals with complex health and social needs stay connected to care as they move between hospitals, clinics, and community services. The role responds to referrals, identifies client priorities, helps arrange appointments, and follows up on connections to care and resources. It also supports clients in understanding Medi-Cal eligibility and health plan options, connecting with enrollment and renewal assistance, and coordinating handoffs to programs including CalAIM Enhanced Care Management (ECM) and Community Supports. This is a non-clinical, non-supervisory role within Integrated Care Navigation.

Work is primarily field-based, with office-based administrative time and telephone outreach. The CHW balances referrals, appointments, messages, follow-up, and documentation, adjusting priorities as needs arise and seeking supervisor guidance when appropriate. The work may involve repeated outreach, clarifying information with providers or health plans, helping gather documents, and confirming whether clients connected with services.

The position is full-time, non-exempt, and scheduled Monday through Friday, with hours that may vary based on program needs. Work occurs primarily in an office setting at 819 19th Street in Sacramento, with coordination across healthcare and community systems, field coordination, and occasional local travel. The role requires frequent sitting, standing, walking, and computer use, and may occasionally involve lifting or moving items weighing up to approximately 15 pounds.

Requirements

• High school diploma or GED.
• One to two years of experience in community health, navigation, outreach, or a related role.
• Working knowledge of Medi-Cal and CalAIM programs.
• Clear, respectful communication and the ability to explain information in an understandable way.
• Strong organization, consistent follow-through, and attention to accurate documentation.
• Cultural humility and experience working with diverse communities.
• Ability to maintain confidentiality and professional boundaries, and seek guidance when needed.
• Valid California driver’s license, current automobile insurance, and reliable transportation for travel within Sacramento County and surrounding areas.
• Completion of required criminal background screening and applicable partner-site requirements.
• Ongoing compliance with organizational policies and maintenance of any licenses or certifications required for the assignment.

Nice To Haves

• Experience supporting Medi-Cal or public benefits navigation.
• Lived experience navigating healthcare or social service systems that the applicant chooses to share.

Responsibilities

• Respond to referrals from hospitals, clinics, shelters, outreach teams, healthcare providers, managed care plans, and community partners.
• Conduct in-person and telephone outreach to clients with approved service authorizations and engage them in the navigation process.
• Complete intake and needs assessments, confirm eligibility, and obtain required consents.
• Identify clients’ immediate priorities and barriers to care and help connect them with appropriate resources.
• Help clients schedule and prepare for medical, behavioral health, and social service appointments.
• Help clients connect to shelter and recuperative care placements in partnership with hospital staff and CoHeWo patient navigation CHWs.
• Support timely connections during care transitions and coordinate handoffs to care management and community support programs, including CalAIM ECM and Community Supports.
• Follow up on referrals, appointments, and outstanding needs, and communicate next steps to clients and partners.
• Help clients understand Medi-Cal eligibility, navigate health plan options, and connect with resources for enrollment and renewal.
• Help clients gather required documents and prepare for enrollment or renewal appointments.
• Coordinate with CoHeWo’s Health & Benefits Access team and other enrollment resources, and follow up to support continuity of coverage.
• Provide understandable information within the scope of the role and seek guidance when eligibility rules or client circumstances are unclear.
• Build respectful relationships and provide culturally responsive, person-centered support.
• Maintain accurate and timely client records, service notes, referrals, follow-up tasks, and outcomes in Salesforce NPC and other approved systems.
• Participate in team meetings and case conferences and coordinate with other CoHeWo teams and external partners.
• Communicate workflow challenges, service barriers, and situations requiring guidance to the supervisor.
• Protect client confidentiality and follow HIPAA requirements and organizational policies.
• Perform other related duties as assigned; responsibilities may change based on organizational or program needs.

Benefits

• Onboarding and guidance on care navigation workflows, Medi-Cal resource connections, and assigned documentation systems.
• Supervisor guidance on priorities, professional boundaries, and situations requiring escalation.
• Team meetings and case consultation to discuss client needs, barriers, and next steps.
• Coordination with Health & Benefits Access and other CoHeWo teams for services outside the role’s scope.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED