See more Collapse

Community Health Worker

1 month ago

Boston, United States Bay Cove Human Services Full time


Community Health Worker - Bilingual Preferred (English/Spanish)

Boston, MA, USA
Req #2728

Tuesday, June 25, 2024

Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental disabilities, mental illness, substance use disorders, and homelessness at more than 175 program sites throughout Greater Boston and Southeastern Massachusetts.

Bay Cove Human Services is committed to ensuring the representation and participation of candidates from diverse backgrounds and experiences. We encourage all qualified individuals, particularly those from historically marginalized groups, to apply.

Job Summary:

The Community Health Worker I (CHW I) provides care coordination and care management for MassHealth Members with complex medical and behavioral health needs who are enrolled in an Accountable Care Organization (ACO) or Managed Care Organization (MCO) plan. The CHW I collaborates with the Community Partner team and the clinical staff of each Enrollee's ACO/MCO's plan to minimize duplicative efforts, promote integrated care, ensure quality and continuity of care, and support the values of person-centered planning, Community First and SAMHSA Recovery Principles. The CHW I is at the helm of organizing and coordinating resources and services in response to the Enrollee's healthcare needs across multiple settings, and inclusive of both LTSS and SDH needs. This role drives assessment and care planning, care transitions, health and wellness coaching, as well as community and social services connections in partnership with Enrollees and their care teams.

This is a non-exempt position.

Essential Functions of the Position:

  • Outreach to and engage Enrollees of an ACO plan as referred to CP Program.

  • Coordinate the completion of the Comprehensive Assessment (CA).

  • Conduct initial and ongoing risk assessment; design personal crisis management plans, relapse prevention and harm reduction strategies with members who have been identified as behaviorally complex in collaboration with team LPHAs.

  • Coordinate the development, implementation, and ongoing review of the Person-Centered Treatment Plan (PCTP) inclusive of any LTSS and / or SDH needs or goals of the Enrollee.

  • Drive referrals regarding connections to any community or social services that align with the Enrollees needs and goals.

  • Submit CA, PCTP and all PCTP updates in accordance with the data sharing agreement CP and ACO/MCO Plan.

  • Collaborate closely with PCP and other providers, including but not limited to community resources, to assure appropriate referrals based on level of care needed to optimize outcomes and minimize risk.

  • Communicate and collaborate with ACO/MCO teams and serve as a team resource.

  • Collaborate with ACO Plan, PCP and other health care providers regarding changes in services, care transitions, crisis intervention while focusing on continuity and quality of client care and potential efficiencies and cost-savings.

  • Obtain required Prior Authorization from ACO/MCO Plan for relevant/necessary services.

  • Manage all care transitions through collaboration with Enrollee, community provider staff, ICT and hospital staff to ensure a safe discharge plan and a well-coordinated implementation of that plan.

  • Ensure completion of medication review by team RN as triggered by a care transition or by a medication change through an outpatient medical or psychiatric visit.

  • Perform other duties, as required.


Job Requirements:

  • Minimum of 3 years case management experience preferred.

  • Experience working with people living with SMI and/or SUD.

  • Preference given to bi-lingual/bi-cultural applicants and those with lived experience of psychiatric conditions. In some cases, experience may be substituted for academic training.

  • High school diploma or equivalent is required.

  • BA/BS in human-services related field preferred.

  • Certified Community Health Worker (CHW) preferred.

  • Driving is a requirement for this position using a personal vehicle. You must possess and maintain adequate insurance as well as maintain a safe driving record which is subject to annual checks. A valid driver's license must be presented at the time of employment. Incumbents must be at least 21 years of age, have maintained a valid US driver's license for at least one year, and must be able to pass a driver's screening background check.

  • Strong commitment to the right and ability of people served to live, work, have meaningful relationships and receive the resources and supports needed in their community of choice

  • Knowledge of person-centered, strengths-based, recovery-oriented values and principles and modalities

  • Knowledge of clinical and psychiatric rehabilitation values, principles, and techniques

  • Knowledge of health risks of prevalence with adults with SMI/SUD

  • Knowledge of health promotion and clinical care coordination techniques

  • Knowledge of motivational interviewing, stage of change and harm reduction techniques

  • Knowledge of trauma-informed and culturally responsive services

  • Sensitivity to the cultural, religious, ethnic, disability, and gender issues

  • Skills and competence to establish supportive trusting relationships with Enrollees

  • Knowledge of human, legal, civil rights, community, and other resources

  • Knowledge of empowerment and self-advocacy techniques

  • Knowledge of available community health, mental health and SUD services and resources

  • Ability to triage/balance competing priorities

  • Ability to make independent judgments and decisions

  • Ability to work in a professional and confidential capacity

  • Ability to work independently and as member of a multidisciplinary team


Bay Cove Human Services does not offer visa sponsorships at this time and will require candidates to be authorized to work in the United States.

Other details
  • Job Family
    Counselor II
  • Job Function
    9B
  • Pay Type
    Hourly
Apply Now
  • Boston, MA, USA


Share this job:

We have other current jobs related to this field that you can find below

  • Community Health Worker

    1 month ago

    Boston, United States Fenway Health Full time

    Job DescriptionJob DescriptionDescription:FunctionCommunity Health Worker (CHW) will with specific target populations on identifying and address Social Determinants of Health (SDoH). CHWs will work closely with medical providers, primary care teams, and other agencies to improve patient care and outcomes. Under the direction of the Nursing Leadership, Care...

  • Community Health Worker, Complex Care

    2 months ago

    Boston, United States East Boston Neighborhood Health Center Full time

    Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center! Everywhere you turn, you can feel the immeasurable level of enthusiasm here at NeighborHealth! We are one of the largest community health centers in the country, supporting the greater Boston area and focusing on the well-being of our patients and...

  • Community Health Worker I

    3 weeks ago

    Boston, United States Massachusetts General Hospital(MGH) Full time

    The Massachusetts General Hospital Down Syndrome Program (MGH DSP) is a collaborative, multidisciplinary team serving people with Down syndrome of all ages and their families. We provide evidence-based clinical care, education, and cutting-edge research so that individuals with Down syndrome can reach their full potential. The Down Syndrome Program is...

  • Community Health Worker Bridges to Moms Programs

    3 weeks ago

    Boston, United States Partners HealthCare Full time

    GENERAL SUMMARY/ OVERVIEW STATEMENT: At Mass General Brigham we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender identity, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us...

  • Community Health Worker Bridges to Moms Programs

    2 months ago

    Boston, United States Brigham and Women's Hospital Full time

    Community Health Worker Bridges to Moms Programs-(3292975) Description GENERAL SUMMARY/ OVERVIEW STATEMENT:  At Mass General Brigham we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender identity, sexual orientation, ability, religion, ethnicity,...

  • Community Outreach Worker

    2 weeks ago

    Boston, United States AmeriCorps Full time

    Community Outreach Worker Community Outreach Workers (COWs) will help vulnerable populations flourish through educational and healthcare attainment by acting as a liaison between Kennedy CHC and the public school districts which house its school-based health centers (SBHCs), Worcester and Framingham. The SBHCs provide high-quality medical, dental and...

  • Community Outreach Worker

    3 weeks ago

    Boston, United States AmeriCorps Full time

    Community Outreach Worker Community Outreach Workers (COWs) will help vulnerable populations flourish through educational and healthcare attainment by acting as a liaison between Kennedy CHC and the public school districts which house its school-based health centers (SBHCs), Worcester and Framingham. The SBHCs provide high-quality medical, dental and...

  • Community Health Worker Bridges to Moms Programs

    2 months ago

    Boston, United States Brigham & Women's Hospital(BWH) Full time

    GENERAL SUMMARY/ OVERVIEW STATEMENT: At Mass General Brigham we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender identity, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us...

  • Community Health Worker Bridges to Moms Programs

    2 months ago

    Boston, United States Brigham & Women's Hospital(BWH) Full time

    GENERAL SUMMARY/ OVERVIEW STATEMENT: At Mass General Brigham we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender identity, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us...

  • Community Outreach Worker

    4 weeks ago

    Boston, United States Jewish Vocational Service. Full time

    Job DescriptionJob DescriptionABOUT JVS BOSTON: JVS is a non-profit, non-sectarian agency. Our mission is to empower individuals from diverse communities to find employment and build careers; and to partner with employers to hire, develop, and retain productive workforces. JVS provides a broad range of services including adult education, skills training, job...

  • Community Outreach Worker

    4 weeks ago

    Boston, United States Jewish Vocational Service (San Francisco) Full time

    ABOUT JVS BOSTON: JVS is a non-profit, non-sectarian agency. Our mission is to empower individuals from diverse communities to find employment and build careers; and to partner with employers to hire, develop, and retain productive workforces. JVS provides a broad range of services including adult education, skills training, job readiness training, job...

  • Community Health Worker I

    3 weeks ago

    Boston, United States Commonwealth Care Alliance Full time

    Why This Role is Important to Us: Commonwealth Care Alliance’s Community Health Services (CHS) Department is responsible for addressing health related social needs (HRSN) and social determinants of health (SDOH) for enrollees in One Care (ICO) and Senior Care Options (SCO) plans. Community Health Workers (CHWs) are key members of interdisciplinary care...

  • Field-Based Community Health Worker

    1 month ago

    Boston, United States UnitedHealth Group Full time

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start...

  • Social Worker

    2 weeks ago

    Boston, Massachusetts, United States Veterans Health Administration Full time

    The VA Boston Healthcare System (VABHS) Mental Health Service is seeking to hire a licensed independent or license eligible social worker who will function as an important member of the clinical teams within the Substance Abuse Residential Rehabilitation Treatment Program (SARRTP). The SARRTP is a 20-bed residential unit for the treatment of substance use...

  • Community Health Worker II

    3 weeks ago

    Boston, United States Commonwealth Care Alliance Full time

    Why This Role is Important to Us: Commonwealth Care Alliance’s Community Health Services (CHS) Department is responsible for addressing health related social needs (HRSN) and social determinants of health (SDOH) for enrollees in One Care (ICO) and Senior Care Options (SCO) plans. Community Health Workers (CHWs) are key members of interdisciplinary care...

  • Coordinator (Community Health Needs Assessment - Community Health Improvement Plan)

    1 month ago

    Boston, United States Boston Public Health Commission Full time

    Job Description The mission of the Boston Public Health Commission (BPHC) is to protect, preserve, and promote the health and well-being of all Boston residents, particularly the most vulnerable. The BPHC envisions a thriving Boston where all residents live healthy, fulfilling lives free of racism, poverty, violence, and other systems of oppression. The BPHC...

  • X-Clinic Outreach Worker

    2 weeks ago

    Boston, United States Codman Square Health Center Full time

    Job DetailsJob Location 637 Washington Street - Boston, MA Description The X-Clinic Outreach Worker reports directly to the X-Clinic Supervisor. The goal of the X-Clinic Outreach Worker is to provide evidence based individual and community level interventions to target populations to increase education, prevention, testing and treatment of STIs in...

  • Per Diem Mental Health Worker

    2 weeks ago

    Boston, United States Bay Cove Human Services Full time

    Per Diem Mental Health WorkerBoston, MA, USA Req #1955Friday, July 26, 2024Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental disabilities, mental...

  • Program Manager Health Communications

    1 month ago

    Boston, United States Boston Public Health Commission Full time

    Job Description The mission of the Boston Public Health Commission (BPHC) is to protect, preserve, and promote the health and well-being of all Boston residents, particularly the most vulnerable. The BPHC envisions a thriving Boston where all residents live healthy, fulfilling lives free of racism, poverty, violence, and other systems of oppression. The BPHC...

  • Maintenance Worker

    4 weeks ago

    Boston, United States Spectrum Health Systems, Inc Full time

    Maintenance Worker Dorchester, Boston, MA, USA Req #3280 Wednesday, June 12, 2024 Since 1969, Spectrum Health Systems, Inc . has been a leader in the field behavioral/mental health treatment....