Community Health Worker Job Opening

Job Summary:
The Community Health Worker (CHW) provides community support for patients within their respective primary care office to help to improve health outcomes for patients with complex medical, social or behavioral needs.

The CHW will provide care coordination services to address health and social needs of identified patients. Together with the Primary Care Provider, Prospect Community Care Manager and other care coordination staff, the Community Health Worker will assist in care plan execution, develop care management strategies for enrolled patients and provide linkages for the various health and social needs of patients. The CHW will work in the field in a variety of settings, including patient homes, medical offices, homeless shelters and the ED/inpatient of ECHN or Waterbury hospitals.

The CHW is responsible, along with other members of Medical Management Team, for contributing to the clinical, quality, financial and patient satisfaction outcomes.

Essential Duties:

• Works under the direction of a clinical lead, in coordination with the Primary Care Clinician, Prospect Community Care Manager and other care coordination staff to determine plan of care management; coordinate care plan and complete tasks as necessary to complete care plan goals.
  
• Key components of the CHW role include:
  • Identification and engagement of community resources
  • Assisting with scheduling medical appointments
  • Facilitating transportation to medical appointments as needed
  • Provide reminder/confirmation appointment phone calls
  • Accompanying patients to appointments as needed
  • Supporting chronic condition management including supporting symptom tracking and reporting, health education/prevention and maintenance of patient’s supplies and durable medical equipment.
• Acts as a peer support for enrolled patients which includes advocacy as patients navigate the medical system and relationship building with individuals and their families
• Attend and contributes to Team Conferences regarding care to/for specific member.
• Coordinates with the care management clinical lead and the Primary Care team to report on patient progress and confer if interventions require modification
• Engages with patients and families across care settings such as the transition from hospital to home.
• Assists the Care Management and Primary Care providers by evaluation of:
  • Basic Needs Assessment; clothing, housing/homeless prevention, limited financial resources, home maintenance repair, referrals, food, safety in the home, transportation, and utilities assistance.
  • Health: provides support to the Social Work Care Manager who will assist with application for medical assistance, insurance enhancements, prescription referral source, education on how to obtain medical equipment, Advance Directives/Hospice choices, dental care referral source, non-compliant issues, and psychiatric condition interfering with medication regiment
  • Family/Social Support; limited social support, parenting/educational skills, domestic violence, elder care, parent-child conflict, family relations issues, recreational activities, and information regarding Respite Care for caregivers.
  • Mental Health; promote referral to primary care or behavioral health clinician who will assess/refer patients to: individual therapy, family therapy, group therapy, anger management, behavior management, suicide prevention and alcohol/substance abuse.
• Assists in completing applications, forms and additional documentation as required. Reviews and verifies the accuracy of required paperwork. Assists with entitlement and other applications, such as ConnPace, T-19, housing, SNF and transportation.
• Attends relevant training as necessary to maintain professional certification and/or knowledge
• Other duties as assigned within the scope of position expectations.

The above are guidelines for the position but are not necessarily a delineation of all actions/duties necessary of the job

Qualification Requirements:

• Minimum of 1 year of experience in community/outpatient settings preferred
• Bilingual (Spanish/English) preferred

Education/Experience:

• Required: High School Diploma or equivalent
• Preferred: Associates degree in Health or Human Service

Knowledge/Skills/Abilities:

• May be required to make face to face visits with patients in a variety of settings: patient home, provider office, Skilled Nursing Facility, etc.
• Requires the ability to travel to multiple office locations; valid driver’s license and automobile that is insured
• Extensive knowledge of available community resources throughout the state to meet the needs of members in the ECHN and Waterbury areas.
• Computer literate: proficient with Excel, Word, and web based applications.
• Excellent written and verbal communication.
• Possess strong interpersonal skills as demonstrated by compassionate, courteous, cordial, cooperative, and professional interaction with diverse groups of co-workers, external business partners and the community.

Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing this job, the employee is regularly required to sit; use hands to finger, handle, and/or feel; and talk and/or hear. The employee frequently is required to stand and/or walk. The employee is occasionally required to climb or balance and stoop, kneel, crouch, and/or crawl. The employee may lift and/or move up to ten-fifteen (10-15) pounds. Specific vision abilities required by this job include close vision.

Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.