The Community Health Worker is responsible for encouraging patient and provider shared decision-making, promoting healthy patient behaviors that reduce risk, improving medication adherence, furthering patient self-management skills and linking the clinical care provided by the Health Center with community-based social supports.
Essential Duties & Responsibilities:
- Work cooperatively with other staff in coordinating patient care and pursuing team-based approaches to service delivery
- Provide linkages for services in community partner agencies to support patients/families social needs.
- Assist in identifying and engaging patients which would benefit from CHW support.
- Establish trusting relationships with patients and their families while providing support, appropriate accountability and encouragement.
- Conduct comprehensive screening/assessment activities including health status, health risks and social needs factors.
- Engage patients/families in the development/maintenance and activation of a comprehensive treatment and self-management plan.
- Provide ongoing follow-up, motivational interviewing and goal setting with patients/families.
- Update Community Resource Manual on a regular basis.
- Establish an ongoing/ trusting relationship with community partners and knowledge of their resources.
- Be knowledgeable of CHW policies and procedures.
- Meet patients in their home, if necessary.
- Maintain documentation of communications via the electronic medical record (EMR). By providing appropriate documentation regarding patient visits, phone notes, patient education, resource information, provider/patient response, etc.
- Appropriate documentation of self-management plan(s), goal setting, and follow-up conversations.
- Maintains proficiency in the use of the EMR
- Receive and return phone calls from patients for information gathering, updates regarding care management meetings, etc.
- Meet monthly productivity goals.
- Documentation during EMR down time
- Completion of EMR down-time processes as appropriate
- Must perform proper documentation on a CHW downtime note and be able to also properly document on downtime phone notes.
- Participates in continuing education services, meetings, mandatory in-services, and performance improvement/OSHA programs
- Maintains patient privacy and protects operations by keeping patient care information confidential in accordance with HIPAA.
- Serves and protects the health center by adhering to professional standards, policies and procedures, federal, state, and local requirements.
- Maintains safe, secure, and healthy work environment by following, and enforcing standards and procedures, complying with legal regulations and OSHA/MIOSHA.
- 401(k) matching
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance