Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below.
General Purpose of Job:This position provides information and servicecoordination for our members identified as need for coordination of multiple services within the community they live. A community health worker has a close understanding of, the ethnicity, language, socio-economic status, and life experiences of the community served. A community health worker liaison will assist members to gain access to needed services and builds individual, community, and system capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, patient navigation and follow-up, reinforce community health education related to specific health plan disease management program(s) information, informal counseling, social support, advocacy, and participation in clinical research.
Essential Duties and Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
- Maintains utmost level of confidentiality at all times.
- Adheres to hospital policies and procedures.
- Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
- Successful completion of a Texas state approved Community Health Worker and Certification Program within 90 days of employment. Continued education is required to maintain Certification.
- Knowledge of Medicaid managed care and health plan processes preferred.
- Medical terminology preferred.
- Prior medical office or hospital experience required.
- Ability to understand complex situations and interpersonal dynamics so as to effectively handle escalated customer and co-worker needs.
- Experience with largely pediatric populations
- Requires a well-organized individual with an excellent capacity for effective time management.
- Requires certification as a Community Health Worker within 90 days of employment and certification must be maintained for continued employment.
- Demonstrates ability to establish and maintain effective working relationships with the provider office staff and peers.
- Demonstrates ability to operate personal computer programs as well as complex medical management software.
- Basic Microsoft Office skills.
- Excellent communication skills, bilingual preferred.
- Community Health Workers are not responsible for conducting any UM review or CM/DM activities that require interpretation of clinical information including non-certification of requests. Licensed health professionals are available for oversight.
- Review daily caseload assigned.
- Confer with Case Manager to ensure understanding of member needs daily prior to home visit.
- Develop professional relationships with, and knowledge of aftercare resources, including their scope and referral process requirements to improve the patient safety into the community.
- Share with and participate in multi-disciplinary team meetings information that will enhance effectiveness and outcome of plan of care.
- Assist with coordination of community resources when necessary (ex: food stamp application, community home repair services, etc.)
- Ability to work independently and as part of a team.
- Assist in collection of structured clinical data and input of various types of information into the complex Case and Disease Management System.
- Maintain visit and telephone turn-around- time stats.
Education and/or Experience:- High school diploma or general education degree (GED).
- Two (2) years prior experience in a managed care organization or medical setting preferred.
- Medical Terminology preferred.
- Must successfully obtain certification as a Community Health Worker.
- Certification must be maintained.
- Prior medical office or hospital experience preferred.
- Basic Microsoft Office skills required.
Certificates, Licenses, Registrations:- Must have a current, valid Community Health Worker Certification in the State of Texas without restrictions. Can be obtained within 90 days of employment. Continuing Education is required and must be completed to continue certification.