Community Health Worker

Multiple Locations
Across Nassau County, FL (Fernandina Beach, Yulee, Callahan, Hilliard) - Just North of Jacksonville

Full-Time |

Make an Impact

Support individuals and families across rural Nassau County by connecting them to healthcare, behavioral h of health, pharmacy, public health, and community resources. As a Community Health Worker (CHW), you will serve as a trusted member of Starting Point Behavioral Healthcare's Mobile Health team and help remove barriers to care, improve health literacy, and connect individuals to services that support their health and well-being.

Working primarily from SPBH's Mobile Health Clinic and community partner locations, you will engage residents, provide approved non-clinical screenings and health education, identify social and healthcare needs, coordinate referrals, and provide follow-up to help ensure individuals successfully access the services they need.

The CHW does not independently diagnose, provide clinical assessment, or deliver medical or behavioral health treatment.

Why Join Us?

We invest in our team and prioritize your success:

• Up to $1,750 Retention Bonus (Year 1) + ongoing tenure-based rewards
• Eligible for PSLF (public service loan forgiveness)
• Health, Dental & Vision Insurance (85% employer-paid for employee coverage)
• Employer-Paid Life Insurance
• 401(k) with 50% Match (up to 6%)
• Generous PTO - vacation and sick leave accrual
• Paid Holidays + Floating Holiday
• Leadership & career growth opportunities
• A supportive and mission-driven culture

What You'll Do

• Conduct community outreach activities throughout rural Nassau County, including mobile clinic stops, partner locations, community events, and other approved outreach settings.
• Engage individuals and families and build trusting relationships using person-centered, trauma-informed, culturally responsive, and motivational communication strategies.
• Provide approved health education related to preventive care, chronic-disease risk factors, behavioral health, substance use, medication access, healthy lifestyles, and appropriate use of healthcare services.
• Administer approved non-clinical social determinants of health (SDOH) assessments to identify needs involving transportation, food, housing, medication access, healthcare access, finances, social support, and other health-related social needs.
• Administer approved behavioral health screening tools in accordance with training and program protocols, which may include PHQ-9, GAD-7, AUDIT, DAST, tobacco-use, and pregnancy screening.
• Conduct or assist with approved preventive physical-health screening and risk-identification activities, when authorized by program protocols and training.
• Recognize screening results, symptoms, or safety concerns that meet established escalation criteria and promptly involve the appropriate licensed professional, crisis resource, or emergency response.
• Connect individuals to medical, behavioral health, substance use, pharmacy, maternal health, preventive health, and social-service resources based on identified needs.
• Initiate warm handoffs and referrals to SPBH and participating CommHIT Everywhere partners using established protocols.
• Assist individuals with appointment scheduling, referral instructions, consent processes, and practical next steps for accessing services.
• Follow up with individuals to determine whether referred services were accessed, identify barriers to completion, and provide assistance within the CHW role.
• Document referral status, outcomes, and unresolved barriers and communicate concerns to appropriate SPBH or partner staff.
• Support transitions among Mobile Health services, SPBH fixed sites, pharmacies, public health partners, primary care, and other community providers.
• Advocate for individuals by helping them communicate their questions, preferences, concerns, and needs to healthcare and community-service providers.
• Promote health literacy, individual choice, self-advocacy, and informed participation in care.
• Identify recurring access barriers affecting rural Nassau County residents and communicate trends and potential solutions to program leadership.
• Accurately and timely document outreach, screenings, education, referrals, follow-up, and outcomes in SPBH and/or CommHIT-designated systems.
• Support closed-loop referral tracking, HIE/ENS-enabled workflows, CommHIT Everywhere Repository reporting, program evaluation, and required state and federal performance reporting.
• Collaborate with SPBH clinical, medical, peer, care-management, and administrative staff; CommHIT CCHWs; FDOH-Nassau; pharmacies; and regional healthcare partners.
• Participate in team meetings, case consultation, training, quality-improvement activities, and workflow refinement as appropriate to the CHW role.
• Maintain confidentiality and comply with HIPAA, 42 CFR Part 2 when applicable, SPBH policies, ethical requirements, and professional boundaries.

What You Bring

• High school diploma or GED required; postsecondary education in health, behavioral health, public health, social services, or a related field preferred.
• Experience in community health, behavioral health, healthcare, social services, care navigation, outreach, or a related setting preferred.
• Relevant work or volunteer experience that supports Florida Certification Board CCHW work-experience requirements preferred.
• Strong communication, relationship-building, advocacy, and care-navigation skills.
• Ability to work effectively with individuals and families from diverse backgrounds and in community-based settings.
• Ability to maintain accurate and timely documentation and follow established protocols and workflows.
• Ability to work collaboratively with healthcare, behavioral health, public health, pharmacy, and community-service partners.
• Ability to recognize situations requiring escalation and appropriately involve licensed professionals, crisis resources, or emergency services.
• Florida Certification Board Certified Community Health Worker (CCHW) preferred at hire. If not currently certified, the employee must be eligible for certification and obtain the FCB CCHW credential within 6 months of employment or assignment to the RHTP Mobile Health Initiative.
• Ability to complete required Initiative 2 screening and referral
• Strong community engagement and trusting relationships with individuals and families.

What Success Looks Like

• Strong community engagement and trusting relationships with individuals and families.
• Effective identification of healthcare, behavioral health, and social needs.
• Successful connection of individuals to appropriate healthcare and community resources.
• Consistent follow-up and closed-loop referral completion.
• Strong advocacy and health-literacy support.
• Timely, accurate, and compliant documentation.
• Effective collaboration with SPBH staff, CommHIT Everywhere partners, healthcare providers, pharmacies, public health agencies, and community organizations.
• Appropriate recognition and escalation of clinical, behavioral health, or safety concerns within established protocols.

Additional Requirements

• Successful completion of required Level II Background, Motor Vehicle Record (MVR), and Drug-Free Workplace screenings.
• Valid Florida driver's license.
• Reliable transportation.
• Ability to meet SPBH driving requirements to operate the Mobile Health Clinic as a driver and spotter.
• Ability to perform the essential functions of the position, with reasonable accommodations available for qualified individuals with disabilities.
• Ability to maintain confidentiality and comply with HIPAA, 42 CFR Part 2 when applicable, applicable laws and regulations, SPBH policies, and professional and ethical standards.