Social & Community ServicesCommunity Outreach & Programs
About the job
Requirements
Excellent written and verbal communication abilities.
Strong interpersonal skills.
Ability to work independently or as part of a team in a fast-paced clinic care-team environment.
Resourcefulness and ability to collaborate with team members and patients.
Knowledge of local population demographics, assets, and needs.
Knowledge of how to facilitate use of the healthcare system, including primary care and specialty linkages and appointment scheduling.
Knowledge of available social services and resources.
Health education skills and knowledge of health promotion, wellness, chronic disease prevention and management, and condition-specific treatment or management.
Skill in identifying problems, problem solving, and resolution.
Sound judgment and decision-making abilities.
Ability to establish and maintain effective communication.
Ability to perform the job in accordance with the employer's Standards of Business Conduct, including compliance, ethics, integrity, confidentiality, protection of assets, avoidance of conflicts of interest and inappropriate business relationships, and billing and collections practices that avoid fraud and abuse.
Time-management skills and ability to prioritize workflow and meet deadlines.
Previous experience working with Microsoft Windows and Excel.
Ability to read, understand, and follow oral and written instructions in Spanish.
Completion of a GED or high school diploma.
One year of community-based experience providing advocacy and support, including significant public contact.
Responsibilities
Collaborate with clinic providers to identify patients in need of community services.
Help patients understand health management plans and goals.
Coach patients in effective management of chronic health conditions and self-care.
Provide training on disease management and healthy living skills.
Connect patients with resources for housing, financial assistance, food, and other critical needs.
Assist patients in using resources, including scheduling appointments, applying for programs, and following up on referrals and appointments.
Advocate for patients to secure community resources.
Provide family support and education as needed.
Motivate patients to participate actively in their health.
Facilitate communication and coordinate services between providers.
Deliver or arrange clinically necessary transportation.
Collaborate with treatment team members and outside sources in delivering care management services.
Collaborate and consult with clinicians, pharmacists, and outside sources in delivering services.
Screen patients competently for suicide risk and other safety concerns.
Complete pre-intake forms and psychiatric assessments, and take actions to connect patients with appropriate levels of care.
Maintain current knowledge of community resources, services, and programs.
Register and enroll patients in HCH programs and collaborate with registered nurses.
Work with the Practice Manager on outreach projects, including SAGE, C & TC, and other assigned projects.
Identify and report barriers for patients and work with clinic resources to develop solutions.
Seek clinical supervision and consultation as needed.
Communicate patient concerns regularly to a supervisor or team.
Accept and apply suggestions for improvement and actively enhance skills.
Document in a timely manner according to RCH standards.
Document interventions, patient responses, progress, follow-through plans, and referrals clearly and concisely.
Document legibly and use the electronic medical record system appropriately.
Obtain signatures for patient contact.
Desired Qualifications
Bachelor's degree in a health-related field.
One year of community healthcare work in a medical clinic.
Flexibility and experience working in a diverse patient environment.
Community Health Worker certification.
Description
Riverland Community Health is a Federally Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work, and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow.
JOB SUMMARY:
The Community Healthcare Worker will work closely with the clinical care team and mental health professionals to connect RCH patients to a wide variety of community resources. The CHW will work with the respective care teams on goal setting, monitoring of goals with the intent of bettering patient experience, care, and outcomes.
ESSENTIAL FUNCTIONS:
Clinical Responsibilities:
Collaborates with clinic providers to identify patients in need of community services.
Assists patients to understand health management plans and goals.
Coaches patients in effective management of their chronic health conditions and self-care.
Provides training on disease management and healthy living skills.
Assist patients with connecting to resources for housing, financial assistance, food and other critical needs.
Assists patients in utilizing resources, including scheduling appointments, assisting with applications for programs and follow-up referrals and appointments.
Advocates on behalf of the patients to secure community resources.
Provides family support and education as needed.
Works collaboratively and effectively within a team.
Motivates patients to be active and engaged participants in their health.
Facilitates communication and coordinates services between providers.
Delivers or arranges clinically necessary transportation.
Effectively collaborates with the treatment team members and outside sources in the delivery of care management services.
Collaborates and consults with the team, including clinicians and pharmacists, and outside sources in the delivery of services.
Competently screens for suicide risk and other safety assessments for patients.
Completes pre-intake forms and assessments for psychiatry and takes actions needed to connect patients to appropriate levels of care.
Continuously expand knowledge and understanding of community resources, services and programs provided.
Register and enroll patients into the HCH programs and collaborate in a team effort with the RN’s.
Work with Practice Manager for outreach projects, such as SAGE, C & TC, and other projects as assigned.
Identify and report barriers for our patients. Work toward solutions with other clinic resources to remove these barriers (e.g., transportation needs).
Supervision and Consultation:
Seeks clinical supervision and consultation as needed.
Regularly communicates concerns regarding patients with supervisor and/or team.
Accepts and employs suggestions for improvement.
Actively works to enhance skills.
Clinical Record Keeping:
Documents in a timely manner per RCH standards.
Documents in a clear and concise manner, addressing interventions used, response to interventions, progress and plan for follow through and referrals.
Documents legibly.
Documents using the EMR system appropriately.
Obtains signatures for patient contact.
Requirements
KNOWLEDGE, SKILLS AND ABILITIES:
Excellent written and verbal communication abilities.
Outstanding interpersonal skills.
Ability to work independently or on a team.
Ability to work in a fast-paced clinic environment as a piece of a care team.
Personal resourcefulness and the ability to collaborate with team members and patients.
Knowledge of local population demographics, assets and needs.
Knowledge and ability to facilitate use of health care system (e.g. primary care and specialty linkages; appointment scheduling etc.)
Knowledge of available social services and resources.
Health education skills, knowledge of health promotion and wellness, knowledge of chronic disease prevention and management and knowledge of health condition-specific treatment or management.
Skill in identifying problems, problem solving and resolution.
Demonstrate sound judgement and decision-making abilities.
Ability to establish and maintain effective communication.
Ability to perform the job in accordance with RCH’s Standards of Business Conduct, which includes compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflicts of interest and inappropriate business relationships. Specifically, work processes that involve billing/collections practices for avoiding activities that constitute fraud and abuse.
Excellent time management skills with the ability to prioritize workflow and meet stringent deadlines.
Previous experience working with Microsoft Windows and Excel.
Able to read, understand and follow oral and written instructions in Spanish.
EDUCATION/EXPERIENCE:
Completion of GED or high school diploma is required.
Bachelor’s Degree in a health-related field preferred.
One year of community-based experience providing advocacy and support which has included significant public contact is required.
One year of community healthcare work in a medical clinic is preferred.
Proven flexibility and experience in a diverse patient environment is strongly preferred.
CERTIFICATES, LICENSES, REGISTRATIONS:
Community Health Worker Certification preferred.
PHYSICAL DEMANDS:
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 15 pounds at times.
SUPERVISORY RESPONSIBILITIES:
None
WORK ENVIRONMENT:
Work is performed in a clinic office environment. Contact with staff, patients and outside agencies. Possible exposure to communicable disease and medical preparations common to clinic environment.
A summary of our benefits include but are not limited to: health, dental, vision, HSA, FSA, basic life insurance, voluntary additional life insurance, spousal and child insurance, long-term disability, and a 403b retirement plan.
In addition, job offers made during flu season are conditioned on the candidate receiving the annual flu vaccination before their start date.
RCH is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.