Community Health Worker – CM
| Company | Evolent |
|---|---|
| Location | Annapolis, MD, USA, California, MD, USA |
| Salary | $45000 – $50000 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Junior, Mid Level |
Requirements
- Valid Driver’s License
- Healthcare background
- Ability to unite with people and comprehend the challenges they face
- Experience assisting patients with Social Determinants of Health (SDoH) needs
- Demonstrated success in working as part of a multi-disciplinary team including speaking and working with Physicians and Registered Nurses
Responsibilities
- Conduct home visits with patients to assist with SDoH barriers or other needs identified by the CM team.
- Engage with patients in person who need assistance with self-care needs beyond what a nurse care advisor can provide via phone.
- Accompany patients to their visits.
- Document activities in the Identifi system, including care plan activities conducted.
- Conduct initial outreach calls to encourage patients and care givers to participate in care management programs.
- Help patient access community and governmental based service agencies including possibly filling out paperwork with/for the patient.
- Arrange transportation.
- Coach and guide the patient to meet both personal and clinical goals.
- Schedule provider visits on behalf of their patients.
- Remind patients of their upcoming visits.
- Address language and cultural barriers to care and self-care.
- Facilitate closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
- Participate in the integrated care team meetings.
- Participate in community health fairs and events.
Preferred Qualifications
- Medical Assistant, Nursing Assistant, Engagement Specialist or Community Health Worker Certification
- Experience working with patients with chronic and behavioral health needs
- Bilingual