Job Description
POSITION DESCRIPTION
Community Health Worker, Adult Behavioral Health Integration
Supervisor: Clinical Projects Manager
POSITION SUMMARY:
As an integral member of both the BNHC Primary Care Teams and the Brockton Board of Health, the Board of Health Community Health Worker (CHW), will have the opportunity to make a profound impact on the lives of people who are living with complex and/ or chronic conditions- reinforcing and building resilience in the context of the COVID Pandemic. This individual will serve to know, understand and guide BNHC patients (or Brockton Community Members seeking primary care medical homes) through connection, reconnection or navigation to or through their medical home. Many of our community members face multiple barriers accessing care and need support to succeed with achieving health care goals. This position is a community integrated CHW who serves as the liaison between the Brockton BOH and the BNHC’s Primary Care teams in support of BNHC and the BBOH’s shared health priorities. This position requires flexibility and may vary from day-to-day to meet patients where they are. Outreach methods may vary based on the needs of the organization and may include telephonic or in person in a variety of potential settings such as but not limited to, the community, home, facility, or health center. This highly independent and skillful CHW is an integral part of the BNHC team, but will be primarily stationed within the Brockton BOH.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Works under the guidance of the Program Leaders (Manager or Director)
- Serves as the liaison between the Brockton BOH and the BNHC Primary Care Integration Team
- Develop and implement outreach plans, in collaboration with BNHC and BOH teams to: identify and reduce the disparities for vulnerable populations disproportionately burdened by the COVID-19 Pandemic in the BNHC Community at large
- Leverages community knowledge, resources and strengths to address barriers/access to primary care for BNHC patients and community members seeking a primary care medical home
- Organize, attend, and participate in strategic stakeholder meetings in support of the program goals
- Identify and share appropriate information, referrals, and other resources to help individuals, families, groups and the primary care team meet their needs
- Gather and combine information from different sources to better understand clients, their families and communities
- Initiate and sustain trusting relationships with the BBOH, local community agencies and partners as well as individuals, families, social networks and primary care team
- Use a range of outreach methods to engage individuals and groups in diverse settings
- Share community assessment results with colleagues and community partners to inform planning and health improvement efforts
- Use effective communication skills
- Act as a cultural mediator by educating and supporting providers in working with patients from diverse cultures to promote health, improve services, and reduce health care disparities
- Addresses language and cultural barriers to care
- Coaches and guides patient/representative to meet both personal and clinical goals
- Assists in health benefits acquisition, appointment on behalf of patient/representative as needed and in support of easy access to primary care services
- Work with individuals, family, community members, and primary care team to address issues that may limit opportunities for healthy behavior. This includes completing Social Determinants of Health (SDOH) screen and other tactics to understand and help reduce barriers to care
- Provide care coordination, which may include but not limited to facilitating care transitions, supporting the completion of referrals, and providing or confirming appropriate follow-up
- Help bridge cultural, linguistic, knowledge and literacy differences among individuals, families, communities, and providers.
- Helps patient/representative access community and government-based service agencies including completing paperwork for the member.
- Helps teach the patient/representative and/or care giver about symptom response plans
- Participates in the integrated care team meetings and rounds as required
- Complies with reporting, record keeping, and documentation requirements in one’s work.
- Use appropriate technology, such as computers, for work-based communication according to health center requirements.
- Creates and maintains a comprehensive inventory of local community resources, improving accessibility for patients and providers, and linking patients with the appropriate support services
- Establishes relationships with community agencies, resources and supports that are relevant to a Medicaid Population.
- Assist with Medicaid applications, food, and nutrition benefits, housing applications, coordinating transportation, etc.
- Participation in BNHC and other designated COVID and important Primary Care meetings as BNHC-BBOH representative
- As needed, cover other areas in person or via telephonic support
- Other duties as assigned
- Demonstrated success in working as part of a multi-disciplinary team including communicating and working with Providers, Nurses, Social Workers, and other health care teams.
- A genuine commitment to Community Health, public health, racial equity and social justice.
- Experience successfully working collaboratively both with internal teams as well as community stakeholders.
- Excellent listening skills, as well as strong written and verbal communication skills.
- Proven time management and organization skills required. Proficiency in data collection and reporting.
- Bi-lingual (preferred)
- Experience working with patients with chronic and Behavioral Health needs
- Must be flexible and adaptable to change.
- Demonstrate the ability to work independently
- Must demonstrate excellent interpersonal communication skills
- Additional desirable qualities include enthusiasm and passion for helping patients, using compassion, empathy and a trauma informed lens.
- Experience using appropriate technology, such as computers, for work-based communication, according to organizational requirements
- Experience and proficiency with Microsoft Office and online record keeping
QUALIFICATIONS:
- Experience within member population preferred
- Community Health Worker Certification Preferred
- Experience working with Medicare, Medicaid and/or Special Needs populations
- A valid driver's license
WORKING CONDITIONS:
A busy Community Health center located in a downtown business district. Occasional long hours may be required.
PHYSICAL REQUIREMENTS:
Physical demands requiring lifting of small pieces of equipment and/or boxes not to exceed 20 pounds. Somewhat sedentary, with interoffice walking and outreach activity required. Visual acuity sufficient for frequent reading. Hearing acuity sufficient for holding conversations with or without audio devices.
At Brockton Neighborhood Health Center, we are dedicated to providing high quality health care that is delivered by Committed, Competent, Compassionate staff who respects the dignity, privacy, and equality of each patient and colleagues. Our team believes that Teamwork, Diversity, Respect, Customer service and Collaboration are essential for everyone to be successful in their role.