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At Oak Street Health, the Community Health Worker (CHW) is the vital link between our patients, their community, and the healthcare system. You are more than a liaison; you are a trusted advocate who meets patients where they are - literally and figuratively - to dismantle the social and physical barriers to wellness. By promoting health literacy, increasing access to resources, and reaching out to patients both in-person and by phone for frequent touchpoints, the CHW helps pave the way for patients to live healthier lives. Working in close partnership with the Medical Social Worker (MSW) and interdisciplinary clinical teams, you will navigate the complexities of housing, food security, and transportation to ensure our patients can focus on their health. This role requires high levels of adaptability, problem-solving skills, strong communication, deep empathy, and logistic planning. Successful candidates have an intimate knowledge of their local community, and a passion to improve the overall quality of patient lives.
Job Responsibility:
Connect patients and help with applications to eligible state benefits and local community resources related to housing, transportation, food, and activities of daily living among other social and physical barriers to health
Facilitate communication between all identified parties involved in patients' care as needed (e.g., family members, caregivers, medical providers, community-based organizations)
Meet with patients in patient-centered and patient-preferred locations (e.g., Oak Street Health center, patient's home, external medical provider facility, community setting). CHWs should expect to spend 50% of their time outside of the clinic
Establish and maintain strong interpersonal relationships with patients, community organizations, team members, and resource partners to coordinate patient needs
Manage patient referrals defined by the care team & collaborate with the Medical Social Worker (MSW) on action plans
Encourage patients to meet health goals set by the care team and celebrate achievements to improve patients' self-efficacy and quality of life
Drive engagement with high risk individuals (e.g., completed specialty appointments, adherence to Post Discharge Visits) may include accompaniment to appointments
Participate in interdisciplinary team meetings to ensure communication and support care team decision-making
Document interactions with patients in electronic medical record (EPIC) in a timely manner, while maintaining HIPAA standards and confidentiality of protected health information
Manage time efficiently by setting priorities effectively. Must be able to work independently successfully while also collaborating with our care team
Other duties as assigned
Requirements:
Minimum of 1 year of experience in a case management type position, either in healthcare, community-based role, or social service environment
Must have a valid driver's license and reliable transportation
Strong oral and written communication skills
Ability to manage multiple priorities in a fast-paced environment
Dedication to serving the community and building meaningful relationships