Community Health Advocate

• manage a caseload of patients and achieve established benchmarks for patient care
• meet patients in their homes, at the hospitals or primary care clinic and conduct open-ended needs assessment to understand broadly what patients’ goals are for their health
• use motivational interviewing to help patients create person-centered action plans for reaching their health goals
• provide a wide variety of support (including emotional support, referral to community-based resources, social services, clinical services, etc.) based on CHW discretion and available resources
• make weekly contact (follow‐up calls and/or home visits) to patients
• coordinate and communicate with clinical care teams to provide relevant information about patient’s goals, clinical emergencies, and patients concerns, and to obtain medical information needed to inform CHW work
• co-facilitate a weekly support group for patients, where applicable
• work with other CHWs and staff to create a directory of community resources (e.g., food banks, housing assistance programs, childcare resources, etc.)
• other duties, as assigned

• High School Diploma required
• long-time resident of assigned location and good knowledge of the resources of these communities
• comfortable with home visits and outreach
• prior experience as an outreach worker a plus
• ability to exercise good judgment with patients, clinical care teams, others involved in the delivery of interventions
• ability to effectively manage time and tasks, prioritize, and stay organized
• excellent oral and written communication skills
• exceptional active listening skills
• proficient in MS Word and computer data entry
• US work authorization

prior experience as an outreach worker

• affordable medical plan options
• a 401(k) plan (including matching company contributions)
• an employee stock purchase plan
• no-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access