Community Health Worker ( Hybrid- Wake/Cumberland Counties, North Carolina)

Alliance Health•Fayetteville, NC

12d•$26 - $34•Hybrid

About The Position

The Community Health Worker uses engagement strategies and strong community connections to assess and assist members in identifying and accessing resources that address unmet health needs. The role also provides education about and connection to member benefits, and serves as a consultant within the Care Team to address barriers related to unmet health needs. Building relationships and trust through community-based engagement is an essential part of the position. This is a full-time hybrid position serving Wake and Cumberland counties, North Carolina. Routine office attendance is not expected, but the employee must be available to report to the Alliance Office for business meetings as needed and may need to travel throughout the Alliance communities in Wake and Cumberland counties. The role conducts social determinants of health (SDOH) assessments, supports member engagement and education, facilitates connections to community resources, collaborates with care teams and providers, provides benefits consultation, and maintains required documentation and compliance. The employee uses systems including Jiva and NCCARE360 to document care coordination and referrals.

Requirements

High school diploma or GED and at least two years of experience working with individuals with behavioral health needs; alternatively, at least four years of lived experience navigating Mental Health, Public Health, Social Service, and/or Justice systems. Other relevant experience, including recovery-focused experience, may be considered.
Alternatively, an associate degree in human services and at least two years of experience working with individuals with behavioral health needs.
NC Community Health Worker Certification required within 12 months of hire.
Valid North Carolina driver license.
Knowledge of Medicaid basic, enhanced MHSUD, and waiver benefits plans.
Knowledge of community-specific financial planning resources.
Knowledge of regulations and statutes specific to 1915(b) and (c) waiver services, including facility-based service licensure types and staffing and supervision requirements, for LTS and TBI Care Managers.
Knowledge of and skill in Motivational Interviewing techniques.
Strong interpersonal and written and verbal communication skills.
Conflict management and resolution skills.
Diplomacy and discretion to negotiate and resolve issues with minimal assistance.
Problem-solving, negotiation, arbitration, and conflict resolution skills to balance internal and external customer needs.
Attention to detail.
Proficiency with Microsoft Office products such as Word, Excel, and Outlook.
Flexibility and adaptability.

Nice To Haves

Training and/or documented knowledge of WRAP, Person-Centered Thinking, WHAM (Whole Health Action Management), Trauma Informed Care, Mental Health First Aid, IPS-SE, Community Inclusion/Integration, Harm Reduction, or the Recovery Model.

Responsibilities

Complete SDOH assessments and reassessments, including Care Needs Screening and Healthy Opportunities assessments.
Review completed SDOH assessments and update activities to address needs identified while completing plan-of-care activities.
Help members engage with additional services and community resources, including Community Inclusion Planning Meetings, before closing a plan of care.
Assess member awareness of and connection to Competitive Integrated Employment or similar supported employment services, as applicable.
Meet members where they are emotionally, socially, intellectually, and physically.
Provide face-to-face and field/community-based support to members.
Help members complete processes to access resources and supports and understand how to use them.
Address SDOH barriers to care and support health promotion, as applicable.
Partner with members and the care team to identify goals and develop member-centered plans.
Educate members about and engage them in care coordination or care management supports, as applicable.
Identify, problem-solve, and work to overcome members’ support needs related to social determinants of health.
Submit referrals and track outcomes in NCCARE360 to connect members with community service providers.
Assist members with applications for resources such as housing, food, transportation vouchers, and childcare assistance, and monitor successful connections to those resources.
Support members in becoming active in their communities, including community organization membership, relationships with neighbors, and development of non-paid social networks.
Review eligibility and connections to internal programs, including flex funds, the Independent Living Initiative, housing programs, and the Community Inclusion Planning Meeting; facilitate community inclusion planning with the Community Health and Well-Being Department.
Refer members for eligibility assessment for Competitive Integrated Employment or similar supported employment services and connect them with services, as applicable.
Attend care-planning and SDOH-related meetings.
Collaborate with the primary Care Manager on needs identified during referral and their incorporation into the plan of care.
Leverage organizational programs and interventions to improve member experience and build social capital in members’ communities of choice.
Develop knowledge of community systems and provide consultation and technical assistance to MCO clinical departments about available resources.
Collaborate with providers and care management service providers for Alliance members.
Represent Alliance in System of Care activities to support an integrated approach for child and adult service systems.
Support Alliance’s Community Engagement team with community capacity, network building, and resource development.
Ensure members understand the benefits for which they are eligible and assist them with enrollment in benefit plans.
Communicate with Medicaid and Medicare benefit program Case Managers to resolve issues.
Assist with Medicaid enrollment, work with DSS to address enrollment issues, and notify DSS of benefit issues while developing action plans to resolve them.
Maintain medical record compliance and quality and complete timely documentation of care coordination activities.
Document in Jiva, NCCARE360, and other identified systems; monitor and review Health Opportunity Assessment and authorization data in NCCARE360.
Support or create a plan of care with the member in the care management platform, as applicable.
Comply with organizational and departmental policies, procedures, processes, workflows, and the Fidelity of Service Engagement Model.