About this role
Description
Position Summary:
The Community Health Worker (CHW) will be responsible for helping patients and their families to navigate and access community services, other resources, and adopt healthy behaviors. The CHW supports providers and the support staff through an integrated approach to care management and community outreach. As a priority, activities will promote, maintain, and improve the health of patients and their family. The CHW will provide social support, advocate for individuals and community health needs, and provide services within scope of practice.
Essential Functions:
1. Responsible for establishing trusting relationships with patients and their families while providing general support and encouragement.
2. Provide ongoing follow-up, basic motivational interviewing and goal setting with patients/families.
3. Follow-up with patients via phone calls.
4. Provide referrals for services to community agencies, as appropriate.
5. Help patients connect with transportation resources and give appointment reminders in special circumstances. Transporting patients is strictly prohibited.
6. Exhibit excellent working relations with patients, visitors and staff, effectively communicating Bluestem’s Health mission.
7. Work closely with medical provider to help ensure that patients have comprehensive and coordinated care.
8. Work cooperatively with other clinical personnel assigned to the same patient.
9. Be knowledgeable about community resources appropriate to needs of patients/families.
10. Be responsible for providing consistent communication to the care team to evaluate patient/family status, ensuring that provided information, and reports clearly describe progress
11. Act as a patient advocate and liaison between the patient/family and community service agencies (i.e. schools, DHHS, hospitals, support groups, etc.).
12. Record patient care management information in the EMR and other software no later than 48 hours after patient contact.
13. Attend regular staff meetings, trainings and other meetings, as requested.
14. Manage assigned caseload of patients.
15. Maintain HIPPA compliance at all times.
16. Other duties as assigned.
Requirements
· High School Diploma or its equivalent, required.
· Background in motivational interviewing/health coaching preferred.
· Written and oral fluency in Spanish and English is preferred.
· Experience working in a multi-cultural setting.
· Experience working in a community-based setting for at least 1 to 2 years preferred.
· Knowledge of some medical terminology preferred.
· Basic computer skills required, electronic medical record (EMR) experience preferred.
· Ability to initiate and maintain positive working relationships with Bluestem Health staff and other organizations.
· Understand the community served, community connectedness.
· Good communication skills, such as listening well, and using language appropriately.
· Ability and willingness to provide emotional support, encouragement and motivation to patients