Community Health Worker

1668

Remote?: 0

Highlights (Bonus, shift, relocation, info for job):

We’re excited to announce that a new medical center will be opening soon in Akron, OH! The location is currently under development, and the exact address will be shared as soon as it's available. Stay tuned for updates on this exciting addition to our network!

Job Summary

This role is a core member of the interdisciplinary care team (ICT), focused on building trust with members and supporting improved engagement in their medical and behavioral health care through promoting compliance with treatment plans.  This involves locating members who have been lost to care or unable to telephonically reach for scheduling hospital/ED follow up visits, providing peer support to members in the community setting and connecting members to community resources to meet social determinants of health (SDOH) needs. The CHW primarily interfaces with members in the community setting, including meeting members in their home or community location.

 

The CHW is knowledgeable of community resources and acts as a liaison between members and resources and helps members complete applications to necessary community-based and in-center services. This role establishes and maintains a trusting rapport with members, families, and relevant stakeholders for a specific assignment or for an estimated 3-6 month timeframe, as indicated, and based on the reason for referral.   

 

This role is key to member success in re-engaging in health care through building in-person relationships with members in their home setting, community locations, accompanying to specialist/PCP office visits and other individual community support. The CHW documents all interactions in the electronic health record, attends team meetings, and serves as a community-based liaison for communication between the member and multidisciplinary team.

 

Key performance indicators of this role include successful engagement with members, member adherence in care (e.g., attending PCP and behavioral health appointments), closing social determinants of health (SDOH) gaps, and overall reduction in member hospital utilization.

Duties and Responsibilities

• Manage an assigned caseload of members with the primary goal of engaging the member into care
• Prioritize outreach to members based on acuity level, difficulty reaching or engaging into care and reasons for referral based on an established list for CHW engagement.
• Outreach to members/caregivers/families in the community to locate, engage, establish trust, and assist in resolving barriers to care.
• Observe the home or community setting to identify needs related to social determinants of health, community integration, family/collateral information, etc., related to members’ health status.
• Document all information and interactions in the electronic health record.
• Develop culturally competent relationships with members
• Promote appropriate utilization of the health care system and AbsoluteCare services to reduce unnecessary ED or hospital admissions.
• Participate in the interdisciplinary care team (ICT) including case consultations, rounds, and follow up.
• Facilitate member enrollment in AbsoluteCare PCP, behavioral health and/or community care management programs
• Support community integration, independent living, and access to care.
• Responsible for prioritizing, independently scheduling visits and following up with members, including reviewing member information prior to outreach.
• Accompany members to medical, behavioral health, and/or community resource appointments to support adherence to treatment plan, advocate for member needs, and assist in completion of applications, as appropriate.
• Work with the member, member’s support system and community programs to establish sustainable SDOH and companion support; when applicable.

Minimum Qualifications

• High School degree or equivalency required.
• Active driver’s license, reliable personal vehicle, and proof of insurance in state of practice.
• 2+ years serving the needs of the local population, preferably in a healthcare setting or community/outreach organization with experience in the following:
• Working knowledge and relationships with community resources and support services
• Cultural competence in working with a diverse population
• Delivering peer support
• Ability to work independently in the field up to 80% of the time in members’ homes or in community locations.
• Strong communication skills to effectively communicate with members, community partners and interdisciplinary care teams
• Ability to build trust and maintain relationships in a culturally competent manner with a diverse population.
• Proven ability to develop and implement creative solutions to locate and engage members into health care and community resources.
• Ability to multi-task, be organized, and think creatively.
• Proficient in Microsoft Suite and ability to learn new technology.

Working conditions

This job operates in the community and within a professional office environment.  This role requires reliable personal transportation to travel to member homes, community settings, and the AbsoluteCare office; routinely uses general office equipment.

Physical requirements

• Ability to communicate clearly and exchange accurate information constantly.
• Ability to travel, drive, walk within the community where members live on a daily basis.

• Ability to utilize IT tools (Laptop, company issued cell phone, hot spot devices, GPS/Safety applications) effectively in the community to document interactions, complete applications, and schedule appointments with the center when applicable.

• Operate personal vehicle daily

• Ability to occasionally move objects up to 20 lbs.

Direct reports

None.

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works. 

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT².

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.