Community Health Worker

5 hours ago

Worcester, Massachusetts, United States Ignyte AI Full time
Job Summary

The Community Health Worker (CHW) plays a vital role in assisting members in managing their health goals in the community. This position works collaboratively with the Point32Health Integrate Care Management team to increase member knowledge, motivation, and adherence to key components of their healthcare.

Key Responsibilities
  • Engage in regular telephonic and in-person member assessments to identify Social Determinants of Health (SDoH) and develop comprehensive care plans.
  • Provide culturally appropriate health education, information, and outreach in community settings, including homes, schools, clinics, shelters, and community centers.
  • Bridge the gap between communities and health and human services by increasing members' health knowledge and ability to be self-reliant.
  • Identify gaps in Health-Related Social Needs (HRSN) that create barriers to members' care and influence unmet needs.
  • Assess health risks and input to members' care plans, partnering with care teams on key care management/care coordination decisions.
  • Assist members in navigating state and federal benefits and applying when members meet qualifications.
  • Assist members in accessing Community-Based Organization resources with referrals and warm hand-offs.
  • Advocate for members to overcome SDoH/HRSN barriers, such as housing, health-harming legal issues, access to healthcare, and other social need barriers.
  • Utilize recovery strategies, such as motivational interviewing, empathic listening, harm reduction, positive behavioral support techniques, limit setting, and strength-based approaches to support members in attaining stated goals.
  • Participate in ongoing education and training to improve skills and role-specific certifications or specialization.
  • Provide consultation and support to other Point32Health team members.
  • Participate in member and provider health education and outreach campaigns as assigned.
  • Provide direct services, including:
    • 1:1 informal health education counseling.
    • Chronic diseases counseling.
    • Social support.
    • Care coordination and provider navigation.
    • Health services enrollment and health insurance navigation skills.
    • Ensure preventive health screenings.
    • Assist with completion of Advanced Directives.
Requirements
  • Bachelor's degree in an allied health discipline (e.g., Health Education, Human Services, Public Health, Community Health, Social Work, etc.) preferred.
  • Credentialed by the Board of Certification of Community Health Workers (CHW certificate) or willing to obtain with assistance of leadership team within one year of employment.
  • 3-5 years' experience as a Community Health Worker in a similar position in a healthcare environment, including 1 year experience with care coordination and/or case/care management, advocacy, community health promotion, resource planning, and community-based visits.
  • Excellent written and verbal communication skills.
  • Working knowledge of Microsoft Office applications.
  • Excellent organizational skills.
  • Ability to utilize an Electronic Medical Record.
  • Strong understanding of the managed care environment with focus on the Medicare/Medicaid population.
  • Strong understanding of federal programs, namely, The Affordable Care Act, MassHealth, Social Security, and Social Security Disability Insurance.
  • Knowledge of welfare reform, homelessness, and community resources to address basic needs such as housing, food, transportation, clothing.
  • Knowledge of barriers encountered by low-income and culturally diverse families.
  • Demonstrated understanding of community services and navigating the healthcare system.
  • Bilingual or multi-lingual.
  • Medical terminology knowledge and proficiency a plus.
Working Conditions and Additional Requirements
  • Must be able to work under normal office conditions and work from home as required.
  • Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
  • May be required to work additional hours beyond the standard work schedule.
  • Must be able to work in a hybrid environment – both virtual work and on-site (at least 1 day a week but occasionally up to 3 days a week as the business requires).
  • Must be within 30-40 minute commute of UM Mass Memorial Medical Center in Worcester, MA.

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