Community Health Worker, IBH

Care New England Health System•Pawtucket, RI

90d

About The Position

The Integrated Behavioral Health Community Health Worker (IBH CHW) is a member of an integrated health care team and works under the supervision of a licensed Behavioral Health Clinician. The role works alongside primary care providers and behavioral health clinicians to support children, adolescents, adults, and families. It is grounded in shared characteristics with the population served and often provides care when patients present to their primary care clinic. The IBH CHW provides health education and care coordination to address care gaps and medical and behavioral health needs. The IBH CHW works with patients with behavioral and developmental health needs to improve health outcomes by assessing strengths, needs, and barriers to accessing care. The role may serve as a point of contact and mentor for caregivers, support access to care throughout the care process, and connect individuals and families experiencing economic or social challenges with community resources. Responsibilities also include patient engagement, education, care coordination, documentation, collaboration with an interdisciplinary team, and adherence to professional and hospital requirements.

Requirements

Bachelor's degree or associate's degree in social work, human services, or a related field preferred.
At least one year of experience working in mental health or substance use preferred.
Experience working with diverse populations.
Professional or volunteer experience in a clinic serving adults and children, a childcare center, or another setting serving children and families.
Knowledge of child development and healthy parenting.
Excellent written, oral, and interpersonal communication skills.
Flexibility and a strong commitment to community health.

Nice To Haves

Experience as a parent, caregiver, or guardian preferred.
Knowledge of school systems and the IEP process preferred.
Knowledge of adult and pediatric mental health services, including CBHI and levels of care.
Bilingual and bicultural candidates are strongly encouraged to apply.

Responsibilities

Engage patients and caregivers and maintain trusting relationships, including outreach to individuals and families lost to care through face-to-face, mail, electronic, telephone, and community contacts.
Monitor and proactively evaluate emerging prevention, wellness, medical, and behavioral health needs in collaboration with the care team.
Help develop and implement attainable goals and action plans, encourage adherence to care plans, and identify and address barriers.
Partner with patients and caregivers to support care plans and continuity of care while respecting patients' values and lifestyles.
Use flexible, evidence-based engagement strategies, including Motivational Interviewing and problem-solving techniques.
Assess symptoms, risk levels, and unmet psychological, physical, housing, and psychiatric needs; provide appropriate crisis intervention and risk management, including calm and professional support during emergencies.
Provide health education about child development, chronic disease, mental and behavioral health, symptoms, diagnosis, management, and available resources and services.
Educate and coach patients and caregivers to strengthen self-management, address access barriers, understand screening and treatment for emotional, behavioral, and developmental needs, and address mental health and substance use concerns.
Collaborate with patients, caregivers, primary care providers, behavioral health clinicians, and other team members to promote continuity of care.
Support referrals and help individuals and families access services for behavioral and developmental health needs.
Identify and build relationships with community resources, including mental health providers, Early Intervention, schools, and local service providers.
Help individuals and families address health-related social needs, including insurance, food, clothing, housing, entitlement and government assistance programs, and other community resources.
Promote completion of care plan goals by assessing readiness for change, addressing barriers, and helping individuals and families change daily routines.
Complete recordkeeping and progress notes in the required format and time frames, following Health Information Services requirements, hospital confidentiality policy, and applicable legal requirements.
Work collaboratively within an interdisciplinary team and independently to provide quality and timely care; manage a population with complex needs and document patient information, interventions, and activities in the electronic health record.
Maintain professional standards, confidentiality, boundaries, and respectful, culturally responsive interactions with patients, families, colleagues, and community partners.
Follow office procedures and infection control protocols, initiate and process incident reports, and maintain cooperative working relationships.
Attend required meetings, trainings, supervision, case presentations, and conferences; participate in relevant committees as appropriate; and share feedback on educational programs attended.
Complete requirements to become a Certified Community Healthworker through the Rhode Island Certification Board.
Communicate constructively with team members, accept supervisory feedback, and incorporate it into work routines.