Community Health Worker

Waikiki Health•Honolulu, HI

8d•Onsite

About The Position

The Community Health Worker (CHW) position aims to improve outcomes for high-need, high-cost individuals by reducing avoidable emergency department reliance, supporting the quadruple aim of better care, lower costs, and enhanced experiences. Responsibilities include patient intakes, education, counseling, and population-based management within clinic protocols.

Requirements

Possess a valid driver’s license and reliable personal transportation.
Able to communicate effectively with patients, staff, and community members.
Proficient with Windows-based programs, confident in typing, internet browsing, and email navigation, and demonstrated ability to master new software platforms rapidly.
Valid Basic Cardiac Life Support certification, renewed biannually.
Completed Occupational Safety and Health Administration safety training.
Proof of TB skin test or chest x-ray.
Proof of Hep B (optional).

Nice To Haves

Completed Medical Assistant, Community Health Worker, or Health Educator program.
Three years of clinical work in an outpatient setting.

Responsibilities

Develop and implement tailored care plans and SMART goals for high-utilizer patient populations to reduce health disparities, improve outcomes, and decrease unnecessary ER/hospital visits.
Administer the PRAPARE screening tool to identify Social Determinants of Health (SDOH) needs, and actively connect patients to community resources, referrals, and program incentives (e.g., transit passes, hygiene kits, cell phones).
Ensure continuity of care by monitoring recently discharged patients and proactively scheduling follow-up appointments within 7 days of their ER or hospital release.
Partner closely with healthcare providers, data analysts, insurers, and community agencies; manage cohort lists and present updates regularly at interdisciplinary Team (IDT) meetings.
Document encounters and vital clinical statistics in the Electronic medical Record (EMR) within 24 hours to 72 hours and maintain SharePoint databases to generate required monthly and quarterly grant reports.
Other duties as assigned