Community Health Worker

AMG Senior Medical Group; Murray (UT); Presencial; USD 29.000 - 32.000; Tempo integral

Resumo da vaga

AMG Senior Medical Group in Murray, UT is seeking a Community Health Worker to support the CMS GUIDE model, focusing on outreach, education, care navigation, and administrative tasks for program participation.

The CHW will serve as a primary contact for patients living with dementia and their caregivers, conducting monthly follow-ups, documenting interactions, and coordinating with partner organizations to promote continuity of care.

Qualificações

• Experience in healthcare, social work, public health, or community outreach strongly preferred.
• Familiarity with dementia care, caregiver needs, and health system navigation is an asset.
• Strong communication, organization, and documentation skills.
• Comfort using EHRs, tracking tools, and CMS-aligned documentation systems.
• Ability to work independently while collaborating with interdisciplinary team members.
• Compassionate, patient-centered mindset with a commitment to improving care for aging populations.

Responsabilidades

• Perform monthly follow-up calls to enrolled patients and caregivers to assess needs.
• Track and document interactions, caregiver needs, referrals, and service updates in CMS GUIDE records.
• Assist with administrative tasks, including GUIDE visit documentation and billing preparation.
• Collaborate with practice's billing and coding team to ensure GUIDE-related encounters are submitted.
• Coordinate annual assessments, caregiver services, and respite referrals as required.
• Attend GUIDE program meetings and support quality improvement initiatives.
• Serve as liaison between patients, caregivers, providers, and community organizations.
• Prepare GUIDE-related reporting and training materials.

Conhecimentos

Healthcare experience

Social work

Public health

Community outreach

Dementia care familiarity

Communication skills

Documentation skills

EHRs

Formação

High School Diploma

Ferramentas

EHRs

Descrição da vaga

Community Health Worker # Community Health WorkerMurray, UT 84123## OverviewSalary Range$21.00 - $23.00 HourlyPosition TypeFull TimeEducation LevelHigh School## DescriptionThe Community Health Worker (CHW) plays a critical role in supporting practice's implementation and ongoing operations of the CMS GUIDE (Guiding an Improved Dementia Experience) Model. The CHW will serve as a primary point of contact for patients living with dementia and their caregivers, focusing on outreach, education, care navigation, coordination with partner organizations, and administrative tasks required for program participation and compliance. This position will begin with a pre-implementation focus on aligning eligible patients for GUIDE visits and transition into ongoing responsibilities that include monthly outreach, documentation, claims support, and caregiver engagement.* Perform monthly follow-up calls to enrolled patients and caregivers to assess needs, reinforce education, and offer connection to resources.* Track and document all interactions, caregiver needs, referrals, and service updates in accordance with CMS GUIDE Model requirements.* Assist with administrative tasks, including confirming GUIDE visit completion, ensuring documentation compliance, and preparing visit records for coding and billing review.* Collaborate with practice's billing and coding team to help ensure GUIDE-related encounters are correctly submitted to CMS, including gathering supporting documentation.* Coordinate annual assessments, caregiver service delivery, and respite referrals as required by the model.* Prepare and support GUIDE-related reporting and quality improvement initiatives, including data entry and summary reports.* Serve as a liaison between patients, caregivers, providers, and community-based organizations to promote continuity and reduce fragmentation of care.* Attend regular GUIDE program meetings and contribute to continuous improvement efforts across workflows and patient experience.* Document outreach efforts and maintain accurate tracking of scheduled, pending, and completed alignment visits.* Coordinate between practice providers and partner organizations such as the Alzheimer’s Association, respite programs, and community services to prepare for GUIDE enrollment.* Participate in care navigator and GUIDE-specific training sessions.* Support administrative setup tasks, including forms preparation, caregiver communication templates, and visit tracking systems.## Qualifications* Experience in healthcare, social work, public health, or community outreach strongly preferred.* Familiarity with dementia care, caregiver needs, and health system navigation is an asset.* Strong communication, organization, and documentation skills.* Comfort using EHRs, tracking tools, and CMS-aligned documentation systems.* Ability to work independently while collaborating with interdisciplinary team members.* Compassionate, patient-centered mindset with a commitment to improving care for aging populations.