Community Health Worker, ID Program

Job Description

Job Description

Position Summary:

Under the direction of the Infectious Disease Program Manager the Community Health Worker will conduct culturally appropriate care coordination, health education and outreach activities in the health centers and within the community. The Community Health Worker will assist patients to access the variety of social and medical services they need to maintain their health. The Community Health Worker will collaborate with the ID Care Team and the patients’ primary care physicians to promote health and wellness and contribute to the goals and objectives of the patients’ care plans. 

Key Functions & Responsibilities

• Establish trusting relationships with patients and their families and provide general support and encouragement.
• Provide ongoing follow-up, basic motivational interviewing, and goal setting with patients/families.
• Conduct intake interviews with patients, including enrolling patients into, and/or referring them to, various health, assistance, and social service programs.
• Complete Self-Management portion of Care Plan and insert for printing
• Follow-up with patients by phone, email, tele-health, and in office visits.
• Assist patients with completing applications and registration forms. Support patient’s access to medication (i.e., basic pharmacy problems, requesting refills, basic co-pay assistance programs).
• Conduct eligibility determination, enrollment, and follow-up with uninsured, and underinsured patients. 
• Assist with coordination of appointments (internal & external)
• Referrals to supportive/enabling services (i.e., transportation, financial assistance, housing, legal, support groups etc.) Transporting patients is strictly prohibited.
• Exhibit excellent working relations with patients, visitors, and staff, community partners, and effectively communicating CCI’s mission.
• Work closely with ID Care Team and primary provider to help ensure that patients have comprehensive and coordinated care. Follow-up with the patient should be continuous from initial identification through closure. Identify barriers to health care access and adherence and communicate to the ID care team.
• Works with the clinical team to support patient follow-up according to established guidelines for Pre-exposure Prophylaxis (PrEP) referrals and tracking list. 
• MADAP (eligibility, enrollment, renewals, etc.) 
• Assess needs and help patients set personal goals to improve/maintain compliance with the plan of care. Provide HIV and general health education based on the area of need.
• Partners with organizations to establish PrEP referral system for patients who are uninsured, as appropriate.
• Work cooperatively with other team members to Identify patients who are at risk of falling out of care and establish engagement and compliance.
• Maintain an updated list of community resources appropriate to the needs of patients/families. 
• Act as a patient advocate and liaison between the patient/family and community service agencies (i.e., schools, Department of Human Services, Health Care for Homeless, hospitals, support groups, etc.). 
• Record patient care management information in the EMR (training provided) and other software no later than 24 hours after patient contact. 
• Follow-up on referrals to DIS at LHDs.
• Participate in Case Conferences.
• Help to maintain and update patient program list.
• Attend regular staff meetings, training, and other meetings as requested.
• Manage an assigned caseload of patients. 
• Working on-site is an essential duty for the job.
• This position may require travel between CCI sites to provide additional coverage when needed.
• Other duties as assigned.

Minimum Requirements

• Minimum High School diploma, an AA or BS degree preferred or commensurate experience.
• Current Community Health Worker Certification, or ability to attain certification within 90 days of employment.
• Experience working in a multi-cultural setting.
• Experience working in a community-based setting for at least 1 to 2 years preferred.
• Basic knowledge of HIV and Sexually Transmitted Infections ( STI’s ) 
• Knowledge of some medical terminology preferred.
• Computer skills required, knowledge/experience with Electronic Medical Records (EMR) is a plus.
• Ability to speak and write English fluently. Bilingual (English/Spanish) preferred.
• Excellent communication skills, such as listening well, and using language appropriately.
• Ability to initiate and maintain positive working relationships with CCI staff and other organizations.

Why work at CCI?

• Extensive benefits plan including PTO
• 403B Retirement Plan
• Tuition reimbursement opportunities
• Continuing education assistance; can be used toward obtaining certifications, renewal of certifications, or possible conference attendance. 
• Our providers are insured for malpractice under FTCA.

Equal Employment Opportunity (EEO)

CCI Health Services does not unlawfully discriminate based on race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer related or genetic characteristics or any genetic information), marital status, sex, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. All personnel decisions are to be administered in accordance with this policy and in compliance with applicable federal and state law, including, but not limited to, decisions regarding recruitment, selection, training, promotion, compensation, benefits, transfers, lay-offs, tuition assistance, and social and recreational programs.

The CEO & President of CCI and all managerial personnel are committed to this policy and its enforcement. Employees are directed to bring any violation of this policy to the immediate attention of their supervisor, Human Resources, or the CEO & President. Any employee who violates this policy or knowingly retaliates against an employee reporting or complaining of a violation of this policy, shall be subject to immediate corrective action, up to and including termination of employment. Complaints brought under this policy will be promptly investigated and handled with due regard for the privacy and respect of all involved.