Community Health Worker

4 weeks ago

Montgomery County MD, United States Evolent Health Full time

Your Future Evolves Here
- Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
- Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
- Join Evolent for the mission. Stay for the culture.
- What You’ll Be Doing:
Our goal is partnering with the nation’s leading health systems in their strategic evolution to positively impact and improve the healthcare delivery system.

Collaboration Opportunities

The Community Health Worker works collaboratively with a team of RN Care Advisors, Social Workers, Pharmacists, Care Coordinators, and Health Educators daily to help coordinate the care of our patients to ensure a holistic approach to helping our patients meet their health goals.

What You'll Be Doing:
The Community Health Worker will work as an extension of the clinical care team. The person taking this role will be assigned patients and will manage their caseload through in-person, telephonic, and electronic communications, and coordination. The Community Health Worker must reside or live within 50 miles of Washington, Frederick
- Conduct home visits with patients to assist with SDoH barriers or other needs identified by the CM team.
- Engage with patients in person who need assistance with self-care needs beyond what a nurse care advisor can provide via phone.
- Accompany patients to their visits.
- Document activities in the Identifi system, including care plan activities conducted.
- Conduct initial outreach calls to encourage patients and care givers to participate in care management programs.
- Help patient access community and governmental based service agencies including possibly filling out paperwork with/for the patient.
- Arrange transportation.
- Coach and guide the patient to meet both personal and clinical goals.
- Schedule provider visits on behalf of their patients.
- Remind patients of their upcoming visits.
- Address language and cultural barriers to care and self-care.
- Facilitate closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
- Participate in the integrated care team meetings.
- Participate in community health fairs and events.

Qualifications Required and Preferred:

- Valid Driver’s License Required
- Healthcare background Required
- Ability to unite with people and comprehend the challenges they face Required
- Experience assisting patients with Social Determinants of Health (SDoH) needs Required
- Demonstrated success in working as part of a multi-disciplinary team including speaking and working with Physicians and Registered Nurses Required
- Medical Assistant, Nursing Assistant, Engagement Specialist or Community Health Worker Certification Preferred
- Experience working with patients with chronic and behavioral health needs Preferred
- Bilingual Preferred

Technical Requirements:
The expected base salary/wage range for this position is $24/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

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