Care Management Community Health Worker
Company: Alameda Health System
Location: San Leandro
Posted on: June 15, 2019
SUMMARY: Provides care coordination and advocacy to patients,
including outreach and engagement, development of the care plan,
linkage of the patient with resources (food, housing, transport,
financial, community based services) as well as linking the patient
with care. DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following
are the duties performed by employees in this classification,
however, employees may perform other related duties at an
equivalent level. Not all duties listed are necessarily performed
by each individual in the classification. 1. Administers risk
assessment or intake interviews with patients and/or families and
records this assessment in the patient's medical record; assesses
patient's level of functioning, environment, appropriateness and
adequacy of support system related to illness and ability to cope.
2. Screens for any barriers to care such as substance abuse,
neglect or housing. 3. Assists in determining relevant goals and
abilities which could include vocational or housing goals. 4.
Intervenes with patients and patient's representatives regarding
emotional, behavioral, and financial barriers to current illness
and/or disability. 5. Pre-screens clients to determine health
care/social service needs and communicates those needs to
professional or paraprofessional personnel as necessary. 6. Serves
a resource and provides counseling and treatment related to
Substance Abuse or palliative care or end of life planning. 7.
Monitor patient's adherence to health improvement or treatment plan
8. Coordinates any appropriate documentation (consents, assessment
tools) to the staff or EHR. 9. Assists with coordination and
delivery of preventive health care programs or in coordination of
housing or vocational placement. 10. Serves as a resource and
coordinates access local community resources and effectively
assists families and patients in accessing appropriate resources to
meet identified needs; coordinates referrals for patients of
community services available and may contact those
agencies/community-based organizations on clients' behalf;
identifies and connects patients to community resources that will
assist them in achieving good health outcomes; recruits volunteers
to attend drug treatment programs at participating drug treatment
centers. 11. Serves as a liaison between Alameda Health System and
community groups by providing information concerning relevant
health/social service/community based programs in Alameda County.
12. Coordinates patients care, such as arrange rides, appointment
reminders, obtain medical records, communicate with specialty
clinics, and care team consult. 13. Provides consultation and
education to team members regarding patient/family (social
determinants) issues and community resources. 14. Analyze client
activities and integrate appropriate program activities/services;
availability of community and governmental services and resources.
15. Coordinates patient care activities with other members of the
healthcare team, the patient, the patient's representatives, and
community partners and makes referrals as appropriate. 16.
Maintains patient records, including patient assessments, plans
interventions, patient/family involvement, outside agency
communications and interdisciplinary contacts. 17. Prepares case
reports; documents assessment, progress notes and related
information as required by Medicare, MediCal, Title 22 and other
mandated regulations according to Department standards; prepares
correspondence regarding patient intake or follow-up.MINIMUM
QUALIFICATIONS: Required Education: High School Diploma or G.E.D.
Preferred Education: Bachelor's degree in a related field (health,
social science or a related field such as psychology or counseling)
or an emergency technician program. Required Experience: Three
years of progressively responsible work experience in a
community-based health care service capacity; or one year full-time
experience in the class of Specialist Clerk or higher with AHS
services performing similar duties, or the equivalent of two years
of relevant full-time experience working in a community outreach
program performing similar duties; experience with Electronic
Health Records (EHRs) and Case Management applications, e.g. Midas
or 3M. Preferred Experience: One year working in a community
outreach program performing duties such as intake, peer counseling,
assessments, program screening, placement and referral.
Licenses/Certifications: Valid California driver's license.
Keywords: Alameda Health System, San Francisco , Care Management Community Health Worker, Healthcare , San Leandro, California
Didn't find what you're looking for? Search again!