Integrated Care Team - Community Health Worker

Under the leadership and direction of the Director of Population Health, and in collaboration with Integrated Care Team leadership, the ICT Community Health Worker plays a pivotal role in supporting care coordination functions, including but not limited to assessment and care planning for patients screening positive for Health Related Social Needs (HRSN), patient engagement strategies, and transitions of care management. The ICT CHW serves as a liaison between the ICT members and external community-based service providers as needed, based on the needs of the patients.  The ICT CHW is committed to continuous professional development within its scope of practice, including acquires and maintaining certification and additional training as applicable. As a care coordinator, manages a caseload of patients and follow them longitudinally to facilitate care planning and achieve goals.

• →Community Health Worker Certification required including a commitment or willing to obtain certification within 6 months of hire.
• →CPR Certified.
• →Bilingual English/Spanish speaking preferred.
• →Working Knowledge of community resources and ability to assess and implement based on assessment.
• →Effective problem solving and critical thinking skills including need for escalation.
• →Demonstrated success in working as part of a multi-disciplinary team.
• →Experience working with patients with chronic medical and behavioral health needs.
• →Demonstrated experience working with diverse patient populations and workforce.
• →Must be flexible and adaptable to change.
• →Strong organizational skills with ability to prioritize, multi-task and independently manage work demands, including escalation to supervisor when needed.
• →Demonstrate the ability to work independently, while collaborating as needed with others if needed.
• →Must demonstrate excellent interpersonal communication and written skills.
• →Additional desirable qualities include enthusiasm and passion for helping patients in a non-judgmental and empathetic nature.
• →Must demonstrate the basics of cultural competence when dealing with a diverse population.
• →Must have a valid driver's license and access to reliable transportation.
• →Must demonstrate a working knowledge of Microsoft Office: Word, Excel, and PowerPoint.
• →Must be willing to learn and utilize telehealth technologies (video, chat), for a variety of services.
• →Willing and able to travel to patients’ homes, and in the community as needed, based on patient’s needs.