Community Health Worker

GREENFIELD

Community Health Worker

PRIMARY RESPONSIBILITIES:

Ensures the provision of high-quality patient care by assisting in daily problem solving as it pertains to Health Center patients accessing health-based needs and bridging gaps between individuals and social services they need within the community

Conducts Outreach, Engagement, and Population Health Activities:

Develops and implements outreach plans in community settings to raise awareness of Health Center services and enroll individuals in need of them. Evening and weekend hours occasionallyrequired
Establish andmaintaincooperative relationships with community-based organizations and other resources to promote client services, care, education, and advocacy
Collaborates with interdisciplinary teams to implement data-driven outreach strategies to re-engage patients in care which target Social Determinants of Health (SDoH), Health-Related Social Needs (HRSN), and gaps in digital health navigation

Provides Additional Patient Support:

Reduces patient access barriers by educating clients on Health Center services byproviding assistancewith registration and scheduling processes as needed
Provides transportationassistancefor patients per Health Center transportationassistanceprotocol. Operates health center vehicle safely andmaintainsdetailed daily activity log and vehicle log per Health Center policies and procedures.
Provides introductory-level technologyassistanceboth virtually and in-person to enable patients to engage with telehealth aspects of care delivery
Provides direct support in the completion of Sliding Fee Discount program applications for potentially qualified Health Center patients

Care Coordination for Health-Related Social Needs

Utilizes Health Center EHR to complete patient screenings, document individual outreach encounters, andcompletesreferrals toCHWteam. Screenings may be used to assess health-related social needs such as housing access and safety, utilities costs, food access, transportation needs, employment, internet access, language barriers, and physical/psychological safety.
Conducts follow-up with patientsidentifiedby staff as having health-related social needs to include members of the dental, behavioral health, and primary care teams.
Usesidentifiedcommunity resource databases to connect patients with social service agencies who provide services foridentifiedhealth-related social needs.Assistswith application processes, as needed.
Usesavailable systems to track services, resource guidance, and patient engagement activities that the CHW conducts to evaluate their impact on patient outcomes.

Case Management

Confers as needed with Health Center clinicians about patient issues and concerns. Assists Health Center providers and staff byprovidingcultural insight into client concerns and treatmentplan.
Identifiesthemselves as a care team member in the Health Center EHR for patients who they haveassistedwith one or more service as a CHW
Works toidentifyand provide community-based eligibility and enrollmentassistanceto the uninsured and current Health Connector membersinMassachusetts.
Works toassistpatients with utilizing telehealth visit access and using the Health Center's EHR patient portal as means to stay connected with their CHCFC care team

Training and Development

Participates in workforce trainings and technicalassistanceopportunities offered by the Massachusetts League of Community Health Centers, among others as direct by supervisorin order tosupport individual skill development and strengthen CHW programs for the Health Center.

Attends and activelyparticipatesin Health Center medical team meetings and other staff meetings asrequired.

Effectively communicates with patients and staff across departments.

Completes CHCFC credentialing process as required per Health Center Policy.

For more details and full job description please see website.