Peer Community Health Worker - Reentry

Job Description

Job Description

JOB SUMMARY

Community Health Workers (CHW) may assist with a variety of concerns impacting individuals and families, including but not limited to, the control and prevention of chronic conditions or infectious diseases, behavioral health conditions, and need for preventive services. Additionally, CHW services can help patients receive appropriate services related to perinatal care, preventive care, sexual and reproductive health, environmental and climate-sensitive health issues, oral health, aging, injury, and domestic violence and other violence prevention services. CHWs tend to be members of the community they are serving and a larger component to linking health and social services for patients.The Reentry Housing Assistant provides direct administrative and program support to the Housing Navigator. This role focuses on supporting clients reentering the community by ensuring accurate documentation, maintaining compliance with funding requirements, and assisting clients with essential housing-related processes. Key responsibilities include:

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assisting clients with completing applications for housing, rental assistance, benefits, and supportive services.
• Collecting, organizing, and maintaining required documentation such as identification, income verification, benefits letters, and rental paperwork in line with program and grant standards.
• Assisting with program workshops related to tenancy education, independent living, and financial literacy in partnership with community providers.
• Preparing reports and assisting with data collection to demonstrate client progress and program outcomes.
• Serving as a point of coordination between clients, Case Managers, and the Housing Navigator to ensure timely communication and resolution of housing-related matters.
• Providing general administrative support including tracking deadlines, maintaining records, and supporting program communications.
• Upholding trauma-informed, client-centered, and culturally sensitive practices in all interactions while maintaining professional boundaries and confidentiality.
• Contributing to continuous program improvement by identifying barriers, sharing feedback, and supporting strategies that strengthen housing services.
• Maintain all data and documentation of housing program in relationship to audit readiness
• Maintaining client files, case notes, and data entry across ECW system to ensure accuracy, confidentiality.
• Supporting the Housing Navigator with rental assistance documentation and payment requests in coordination with the Finance Department.

Performs a combination, but not necessarily all, of the following duties:

Outreach and Engagement – includes street, community, and online outreach to inform and educate community members and institutions about St. John’s and partner agency’s services and supports, and to engage individuals and families relative to those services.

Health Education – provide education to individuals, families, and communities surrounding general and specific health conditions and services to include, but not limited to, diabetes, heart/coronary disease, pulmonary disease, hypertension, HIV/AIDS, hepatitis, sexually transmitted infections, substance use disorders, mental illness, and the social determinants of health and how addressing these helps to improve overall medical and psychological well-being.

Screening and Linkage to Care – conduct various brief screenings with individuals and families to determine service needs and provide linked referrals with warm handoffs to services within St. John’s and in the community, ensuring services are those most culturally relevant to the individual/family.

Assessment and Service Planning – assess individuals and families using approved tools to measure whether the SDOH are sufficiently addressed. Create individual and family service plans and document service needs, action plans, and progress on meeting SDOH necessities.

Case Management, Care Coordination, and System Navigation – assist individuals and families in identifying the most culturally competent and relevant services in relation to the service plan, whether internal to St. John’s or within the community, and provide direct linkage, warm handoff, and follow up on all referrals wherever possible. Ensure appropriate communication between all medical and psychosocial service providers, both internal and external, to coordinate clinical and logistical needs in order to best serve patient outcomes.