R-362351
Working within an interdisciplinary care integration team (CIT), the Community Health Worker is responsible for proactively engaging patients and serving as the linking role between a patient, their community, and their healthcare ecosystem including PCP and other specialists, and implementing targeted interventions to address barriers to health and increase access to care.
This role requires outreach strategies to engage patients at least weekly, providing culturally appropriate health education, advocate for needs, facilitate communication between key stakeholders in the patient’s community (e.g., facilitate coordination with local food bank) and health care providers (e.g., coordinate visits, review annual wellness visits, and education materials, and engage people on the complex items healthcare stakeholders are sharing with them to help establish a question list for their next appointment and work with patients to help navigate).
Required Qualifications
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