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Candidates must reside within NorthLakes' service area at the time of hire and maintain residency throughout employment.
The position’s main purpose is to connect people with support and resources to improve overall health and wellbeing. The CHW works with each person to build on their strengths, reduce barriers to care, and improve important aspects of life (financial, safety, physical, emotional, etc.). The CHW plays a key role in our efforts to provide comprehensive and integrated care to all patients.Essential Job Functions
Essential Functions of the Job: [Other duties may be assigned.]
Administer assessment of whole-person needs for social drivers of health, including housing, economic stability, social networks and supports, access to healthcare, access to food, stress, wellbeing and safety
Identifies patients meeting criteria for care management services
Collaboratively develop a plan based on personal goals, and connect people to resources and supports to achieve said goals
Provide informal counseling and support, screenings, and referrals
Establish trusting relationships with patients and their families
Provide ongoing follow-up, basic motivational interviewing and goal setting with patients/families
Maintains follow-up care with patients through phone contact and office visits, while at the same time encouraging and fostering self-management
Connect people to healthcare and social services through referrals, warm hand offs and follow-up
Keep up to date on community resources and services and how to access them, and facilitate system navigation
Help people keep appointments, including appointment reminders
Manage care transitions for vulnerable populations
Connect people to the Sliding Fee program, NorthLakes Care, and other programs
Assist in completing applications and registration forms
Conduct eligibility determination, enrollment and follow-up to enroll individuals into health insurance plans, including CAC duties
Work closely with care team to ensure people have comprehensive and coordinated care
Act as an advocate and liaison between the person/family and service agencies (i.e. schools, Department Human Services, Heath Care for Homeless, hospitals, support groups, etc.)
Manage assigned caseload of participants
Attend regular staff meetings, trainings and other meetings as requested
Collect program data and relay information
Record patient care management information in the EMR and other software
Understand and demonstrate knowledge of HIPAA
Develop and maintain relationships with organizations and agencies providing health and social services
Maintain and disseminate updated resource information
Work with Department Manager to identify community involvement and outreach needs
Other duties as assigned
Qualifications and Education Requirements
· A Bachelor’s Degree (B.A or B.S.) preferred, with 1 year of relevant experience in community-based settings
· Position must keep current on information pertaining to community resources and services.
Preferred Skills
· In-depth understanding of communities served
· Strong psychosocial background
· Relevant experience in case management
· Ability to interact with physicians & other health care professionals in a professional manner
· Strong interpersonal and communication skills
· Adaptable to change
· Proficient in Microsoft Office
· Keeps all matters related to the organization confidential in accordance with HIPAA and the confidentiality policies and procedures.
Benefit Statement
For full time and part time employees who work 24 or more hours per week we offer a generous benefits package that includes:
Medical and dental insurance
Employer paid group term life and disability
Employer contribution toward Health Savings Account
Flexible Spending Accounts
Paid Time Off (PTO), Paid Holidays and Paid Leave Bank
403(b) with a 4% employer match
Various voluntary benefits:
Vision Insurance
Supplemental Life, AD&D and Disability
Tuition reimbursement
Health and Wellness reimbursement program
Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
Partner of HRSA/NHSC loan repayment program
Our Mission is to respond to the healthcare needs of our communities with an integrated array of quality services and actively remove barriers to wellness.
NorthLakes Community Clinic is an Equal Opportunity Employer. All qualified applicants will be considered for employment regardless of age, race, color, creed, religion, sex, sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
All offers of employment are contingent upon successful completion of a criminal background check and references.
At NorthLakes Community Clinic, our organizational competencies highlight the behaviors and values that guide how we work and provide a shared foundation for performance, development, and growth throughout an employee’s career with us.
NorthLakes Community Clinic Organizational Competencies
Mission Driven - Advances the organizational mission, vision and values in executing job duties.
Customer Service - Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.
Quality - Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Creativity - Generates new ideas, supports change, provides innovative solutions, solves problems creatively.
Integrity - Earns the trust and confidence of coworkers and customers through honest communication, ethical behavior and professionalism in all interactions.
Teamwork - Contributes to meeting team deadlines and responsibilities, listens to others and values opinions, helps team to meet goals, welcomes newcomers and promotes a cooperative team atmosphere.
Self-Development - Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities.
Job Knowledge - Understands duties and responsibilities, possesses necessary job knowledge and technical skills, maintains job knowledge current.
Communication - Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills.
Dependability - Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
Trauma/Resilience Informed - Understands that trauma is prevalent and resilience can be cultivated and improved; and operates in a manner consistent with these principles.
