Community Health Worker

COPE Health Solutions•Santa Rosa, CA

About The Position

The Community Health Worker (CHW) helps patients and their families navigate and access community services and other resources, and supports healthy behaviors. The CHW supports providers and Case Managers through integrated care management and community outreach, with the aim of promoting, maintaining, and improving patients’ and families’ health. The role provides social support and informal counseling, advocates for individual and community health needs, and serves as a liaison between members and services. The CHW educates members about Enhanced Care Management (ECM) services, assists with enrollment, and supports members as they navigate the health care system and develop self-care and health care management skills. The CHW builds trusting relationships, provides encouragement and follow-up, helps members set goals and attend appointments, and works to remove barriers to health and social services. The role includes face-to-face outreach, meeting members in clinics, facilities, homes, or other settings, and coordinating with care teams and community organizations. The CHW manages an assigned caseload, documents member interactions and care management information in the EMR and other software within 24 hours of contact, and maintains HIPAA compliance. The position is based in Santa Rosa, California, with travel up to 80%. It is listed as regular work and offers both full-time (40 hours) and part-time (20 hours) schedules.

Requirements

Valid California Driver’s License.
High school graduate or equivalent required.
Experience working in a multicultural setting.
Willingness to learn and understand different cultures, perspectives, and norms.
Basic computer skills required.
Understanding of the community served and community connectedness.
Good communication skills, including listening well and using language appropriately.
Ability and willingness to provide emotional support, encouragement, and motivation to patients.
Good organizational skills to handle multiple priorities while remaining professional and calm.
Ability to work with diverse people, including children and teenagers.
Effective telephone skills.
Strong confidentiality due to the sensitivity of materials and information handled.
Ability to suggest improvements to workflow or system efficiency and effectiveness.
Ability to work independently, be self-directed and flexible, and prioritize work.
Ability to perform functions with minimal supervision and maintain accuracy at a high-volume level.
Commitment to the mission of the COPE Health Solutions ECM Program, professionalism, respect, honesty, dignity, excellence, and teamwork.
Ability to meet the role’s travel requirements of up to 80%.

Nice To Haves

Associate’s Degree in Business Administration or a related field.
Successful completion of a formal Community Health Worker training program from a college or other educational institution.
Written and oral fluency in English and Spanish.
At least 1 to 2 years of experience working in a community-based setting.
Electronic medical record (EMR) experience.

Responsibilities

Educate members about ECM services, assist with enrollment, and serve as the primary liaison between members and services they may need.
Support individuals and families as they navigate the health care system and transition toward improved self-care and health care management.
Establish trusting relationships with patients and families and provide general support and encouragement.
Provide ongoing follow-up, basic motivational interviewing, and goal setting with patients and families.
Bridge conversations with members and remove barriers to accessing health and social services.
Conduct face-to-face outreach to assigned members for appointment scheduling, needs assessment, and care gap closure.
Meet members in clinics, facilities, homes, or other settings to identify social determinants of health affecting their health and well-being.
Collaborate with the care team to create individualized, linguistically and culturally appropriate care plans for enrolled members.
Assist members in accessing health-related services and community resources, including accompaniment to specialist appointments and help with enrollment forms.
Facilitate communication among members, families, colleagues, and community-based organizations as needed.
Document member interactions and care management information in the medical record, EMR, and other software within 24 hours of contact.
Follow up with patients by phone, home visits, and visits to other settings where patients can be found.
Help patients set personal health-related goals and attend appointments.
Refer patients to community agencies and services as appropriate.
Help patients connect with transportation resources and provide appointment reminders in special circumstances.
Work closely with medical providers and other clinical personnel to support comprehensive, coordinated care plans.
Maintain knowledge of community resources appropriate to patient and family needs.
Communicate consistently with the Case Manager to report and evaluate patient and family status and progress.
Act as a patient advocate and liaison between patients, families, and community service agencies.
Manage an assigned caseload and maintain HIPAA compliance.
Maintain professional working relationships and communicate the organization’s mission effectively.
Remain available to work weekends as required by program and operational needs.
Be punctual, use time appropriately, and perform assigned work conscientiously, cooperatively, and accurately.
Maintain a professional appearance and protect confidential information concerning program operations, patients, and employees.