The Community Health Worker (CHW) provides support and role modeling related to the improvement of life skills and health/wellness to individuals and their families during personal interactions including home visits, telephone calls, etc. Instructs individuals and their families about wellness, chronic disease prevention and self-management. This position involves engaging in care coordination activities which include working closely with health care providers, community partners, and/or individuals served to address social drivers of health and reduce barriers to access care. The CHW will assist persons served and their families with accessing appropriate community resources, coordination of group support programs and provide ongoing contact. The services provided by the CHW are person-centered, empowering individuals to advocate for themselves and receive personalized care.
JOB DUTIES:
- Provide activities of care coordination including:
- Facilitating effective communication among health care providers and supporting collaboration across settings and providers.
- Information sharing across various health care providers and community agencies.
- Supporting continuity of care to support smooth transitions between different settings and prevent gaps in service and to promote support and follow-up for persons served.
- Engage persons served to be actively involved in their care and empowered to make decisions related to their care and treatment.
- Participates in community events and activities that promote awareness in relation to mental health.
- Conducts home visits to determine consumer and family needs. Assists with relaying identified needs and provides services. Follows up with consumers, families, and community agencies to evaluate effectiveness of services provided and to develop a proactive plan for future needs.
- Assists consumers with arranging and keeping medical appointments.
- Assists consumers in accessing community resources such as food, clothing, shelter, and medical insurance.
- Mentors, empowers and advocates for consumers and families to help them increase independence and skills.
- Communicates and collaborates with the consumers and their families, staff, and other professionals involved in the care of consumers to coordinate services and to facilitate a supportive relationship between the consumer and their health care provider(s).
- Serves as a resource to staff about situational and cultural factors impacting the consumer, family, and environment.
- Teach consumers and families about wellness, disease prevention, and self-management.
- Documents services provided including progress on goals related to health/wellness, resources, education, and other pertinent CHW contacts. Documents trends and changes in the health of the community and provide input into CHW program development and evaluation.
