JOB SUMMARY:
The Community Health Worker (CHW) serves as a point of contact and a resource for patients and families around community-based needs, building trusted relationships that support participation in care and connection to local resources. Working in close collaboration with the RN Case Manager and interdisciplinary Care Team, the CHW assists patients with meeting goals and needs outlined in the care plan. The CHW completes outreach, networking, and coordination with community partners and resources, providing an added layer of physical, emotional, and social support that empowers patients to actively engage in their health and well-being.
This position in located primarily in Fort Bragg, CA and serves the Mendocino Coast but may require driving to serve patients throughout Mendocino County. Being bi-lingual in English and Spanish is a preference for this opening. The schedule will require full time (8 hours) availability for Thursdays with remaining weekly hours spread across the other 4 weekdays. There may be variation and flexibility in the spread of remaining hours across Monday, Tuesday, Wednesday and Friday.
ESSENTIAL JOB FUNCTIONS:
- Meets with patients in the community (including home visits) to assist with completing needed documentation, facilitate a video conference with a clinical staff member, and/or support patients’ personal needs.
- Provides support and follow-up in collaboration with the Care Team. This includes active listening, directing patients to each discipline within the Madrone Care team when appropriate, and acting as a resource for information on community services, referrals and the process for patients to gain assistance or seek help gaining access to resources.
- Helps patients with personal needs (errands, mileage reimbursement, coordination of care for non-MCN provider appointments, access to food resources) per care plan. Delivers supplies to patients including food boxes, durable medical equipment and paperwork.
- Supports patient enrollment process for service and benefits, collaboratively assisting interdisciplinary team members and providers when requested.
- Facilitates visits and use of teleconferencing software for patients and supports members of the interdisciplinary team in Advanced Care Planning.
- Participates in plan of care task execution and consults, coordinates and collaborates with the interdisciplinary team and others involved in the patient’s care to contribute to the overall continuity of care.
- Communicates with patients and families via phone, video technology and home visits per care plan and facilitates video conferencing during home visits with interdisciplinary team members when needed.
- Reminds patients about appointments and attends medical appointments with patients when appropriate.
- Communicates any changes in the patient’s condition or needs to the RN Case Manager and Care Team in a timely manner.
- Charts all patient encounters and appropriate patient care information in the electronic health record (EMR) within 24 hours.
- Performs vital checks during scheduled visits and upon request form the RN Case Manager or Provider.
SECONDARY JOB FUNCTIONS:
- Model The Madrone Way by delivering patient- and family-centered care that is holistic, respectful, flexible, and grounded in compassion and clinical excellence. Provides clear communication, empathetic service, and collaboration across disciplines
- Uphold privacy and professional standards, maintaining full HIPAA compliance, following all organizational policies and procedures, and demonstrating sound judgment and integrity in all tasks.
- Foster collaborative relationships with internal teams, community partners, and caregivers by demonstrating strong listening, communication, and conflict resolution skills.
- Stay organized, with attention to detail and readiness to respond to changing volumes, urgent needs, or evolving care requirements.
- Support team wellbeing and sustainability by practicing safe work habits, helping maintain operational flow, and contributing to a workplace focused on staff growth, resource alignment, and the long-term success of MCN’s mission.
- Support day-to-day operations and perform other duties as assigned, aligned with patient, caregiver, and community needs—and in service of the organization’s commitment to walk with patients as they live the remainder of their lives.
- Ensure that all charting and updates to the patient electronic medical record are completed within deadlines and foster communication between teams to provide the highest level of patient care and contribute to efficient practice operations.
- Observes and reviews the patient’s and caregiver’s understanding and ability to carry out self-care activities during routine interactions. Identifies potential gaps, challenges, or concerns related to symptom management, daily routines, medications, or adaptive behaviors, and promptly escalates observations to the appropriate clinician. Supports reinforcement of education by confirming that information previously provided is understood and being applied, and reports outcomes or concerns to the care team.
ESSENTIAL EQUIPMENT, TOOLS OR MACHINERY:
The following equipment, will be necessary to effectively perform the job functions described:
- Laptop computer or I-pad
- Cell phone
- Facsimile machine
- Photocopier/scanner
- Personal vehicle
- Video conferencing technology
PHYSICAL REQUIREMENTS:
The following physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.
Work locations will vary and frequent driving is required. Work may be conducted from MCN’s office, a patient’s residence, public community locations, residential care facilities, physician offices, hospital locations or other locations where a patient may reside or receive care. Requires frequent use of computer platforms and electronic medical records.
Ability to sit for extended periods, as well as frequent walking, standing, bending, and reaching.
Ability to use hands and fingers to operate office equipment, type, handle paperwork, perform data entry tasks, complete medical chart updates, deliver supplies to patients and drive.
Ability to hear and communicate effectively verbally and in writing with patients, caregivers, team members, and community partners, with or without reasonable accommodation.
Ability to read, review, and analyze written documents and electronic records and drive to meet and deliver to patients.
Ability to lift, carry, or move items weighing up to 25lbs.
The work environment includes patients’ homes and community locations and may involve exposure to bodily fluids, communicable illnesses, pets, smoke, environmental allergens, uneven surfaces, and varying home conditions. Adherence to established safety, infection control, and PPE guidelines is required. May involve exposure to unknown or potentially hazardous household chemicals, cleaning agents, or substances not under the organization’s control. Employees are expected to follow Cal/OSHA safety standards, hazard awareness training, and safety protocols.
QUALIFICATIONS:
- Experience as a caregiver, Certified Nursing Assistant, or Home Health Aide is preferred
- CPR or Basic Life Support - Preferred
- Current California Driver’s License, auto insurance and vehicle registration
- Bi-Lingual in Spanish - Preferred
- Advanced computer skills and experience in electronic medical records is preferred.
- Capacity to remain organized, prioritize and multi-task and work independently with minimum supervision.
- Ability to demonstrate respect and professionalism toward all patients, caregivers, and colleagues, regardless of their circumstances, ethnicity, race, sexual orientation, gender identity, religious beliefs, or political affiliation.
Job Type: Part-time
Pay: $24.00 - $25.00 per hour
Expected hours: 16.0 – 20.0 per week
Benefits:
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Paid jury duty
- Paid time off
- Retirement plan
Language:
- Spanish and English Fluently(Are you Bi-lingual) (Preferred)
License/Certification:
- California Driver's License (Required)
Shift availability:
Work Location: In person
