Field Based Community Health Worker; CHW - Rhode

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The Field Based Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care. They also identify and initiate referrals for social service programs—including financial, psychosocial, community and state supportive services—and manage the care plan throughout the continuum of care as a single point of contact for the member.

As a Field Based Community Health Worker (CHW), you will act in a liaison role with Medicaid members to ensure appropriate care is accessed, as well as to provide home and social assessments and member education. The coordinator also addresses social determinants of health such as transportation, housing, and food access.

If you live in the state of Rhode Island, you'll enjoy the flexibility to telecommute
* as you take on some tough challenges.

Working

Schedule:

Monday through Friday, any 8‑hour shift to be determined by the hiring manager between the hours of 7 am to 6 pm. This position is a field‑based position with a home‑based office. You will work from home when not in the field.

Location: State of Rhode Island

Local travel up to 50% and mileage is reimbursed at the current government rate.

• Assess, plan, and implement care strategies that are individualized by patients and directed toward the most appropriate, least restrictive level of care.
• Utilize both company and community‑based resources to establish a safe and effective case management plan for members.
• Collaborate with patients, family, and healthcare providers.
• Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services.
• Communicate with all stakeholders the required health‑related information to ensure quality coordinated care and services are provided expeditiously to all members.
• Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team.
• Document all member assessments, care plan and referrals provided.
• Accountable to understand role and how it affects utilization management benchmarks and quality outcomes.
• Be flexible, adaptable, and patient in all types of situations.
• Engage members either face‑to‑face, telephonically, or virtually.
• Work with Medicaid/Medicare population to address gaps in care, social determinants of health, and disease management.
• Help members set person‑centred SMART goals and develop a care plan to achieve those goals with regular follow‑up calls and ongoing documentation of progress toward goals met.
• Adhere to detailed, specific documentation requirements in the member's health record.
• Proactively engage members to manage their own health and healthcare using Motivational Interviewing skills.
• Help the member engage with mental health and substance use treatment as needed.
• Employ strong skill sets of managing multiple tasks, being self‑motivated, driven toward quality results, managing time well, being very detail‑oriented and organised, working well in a team and independently, and managing multiple deadlines.
• Perform other duties as assigned.

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays.
• Medical plan options along with participation in a Health Spending Account or a Health Saving Account.
• Dental, Vision, Life & AD&D Insurance along with Short‑term disability and Long‑term disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).