Care Specialist Community Health Worker

4 weeks ago

Bronx, New York, United States Upward Health Full time

About the Role

As a Care Specialist at Upward Health, you will play a vital role in delivering high-quality care to our patients. Your primary responsibility will be to conduct direct outreach to patients via phone, in-person, mailings, and other strategies to enroll them into our program and collect key data about their needs.

Key Responsibilities

  • Conduct needs assessments, including helping patients set health goals, and facilitate in-home provider appointments to coordinate care between patients and the care team.
  • Support patients in meeting their healthcare goals as it relates to Quality measures and work within an interdisciplinary team to support the team's effort in meeting market and/or organizational goals.
  • Obtain and record vital signs and other health information in electronic medical records and analyze patient data to determine patient needs or treatment goals.
  • Cultivate and support primary care providers with timely communication, inquiry follow-up, and integration of information into the care plan regarding transitions-in-care and referral.
  • Build rapport with Upward Health patients utilizing motivational interviewing techniques and conduct one-on-one extended in-person patient appointments.
  • Makes follow-up calls and home visits to patients per Upward Health policy and documents each patient encounter with accuracy and precision.

Requirements

  • At least 2 years of relevant work experience as a Community Health Worker, Peer Support Specialist, Medical Assistant, or similar role.
  • High school graduate or GED required.
  • A valid driver's license and auto liability insurance.
  • Reliable transportation and the ability to travel within your assigned territory or other as needed to support the patient needs plan and training requirements.
  • Experience in Chronic Care Management model OR experience with chronically ill/elderly patients.
  • Long-time resident of the community with good knowledge of the resources of this community.
  • Ability to complete Upward Health's initial training program and ongoing educational requirements as assigned, both virtually and in-person.
  • Technologically savvy with basic computer skills, including ability to type.
  • Multi-lingual capabilities preferred, but not required.

About Upward Health

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our providers, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.

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