Community Health Worker- ACO (Accountable Care Organization)

1400 Baystate Medical Practices, Inc; United States; On-site; USD 27,000 - 47,000; Full time

Job summary

The Community Health Worker (CHW) at Baystate Health collaborates with care teams to help patients navigate health and community services, promote healthy behaviors, and provide culturally appropriate education. The role emphasizes social support, self-management coaching, and effective communication among patients, providers, and community resources to reduce barriers to care.

Based in the Baystate Administrative Office in Springfield, MA, the CHW works full-time, 40 hours per week, first shift

Qualifications

• GED or HiSET required (or willingness to enroll in CHW certification)
• Preferred exposure to community settings
• Reliable transportation and MA Driver's license is required

Responsibilities

• Develop drive to learn and grow in the CHW role and engage with patients, families, and medical team
• Outreach to a specific patient population, including home/community visits as needed
• Reduce cultural and socio-economic barriers by working with diverse populations
• Assist with medication adherence, appointments, and transportation as needed
• Serve as a key contact for enrollment and educate patients on healthcare delivery
• Identify and utilize community resources and assist with scheduling and referrals
• Communicate effectively with providers and clinical team within a multidisciplinary group
• Build positive relationships with clients, providers, supervisors, and staff
• Expand knowledge of community resources, public health, and evidence-based programs
• Document all activities in EMR and community service plans clearly and concisely
• Perform Care Needs Screenings and coach patients on chronic condition self-management
• Deliver culturally and linguistically tailored education and support

Skills

Community outreach

Cultural competency

EMR documentation

Patient education

Care-team collaboration

Education

High School diploma / GED

Tools

EMR systems

Job description

SCHEDULE:

Full-time, 40 hours/week 1st shift, 8am-4:30pm No weekends or holidays

LOCATION:

Baystate Administrative Office Springfield, MA

Summary:

The Community Health Worker (CHW) is developing skills to help patients and their families navigate and access health and community services while adopting healthy behaviors. The CHW work as a care team member through an integrated approach to care management and community outreach. The CHW is developing skills to effectively promote, maintain, and improve the health of patients and their families by providing social support and informal counseling. The CHW develops strong relationships within the care team and partners with providers, patients, and outside organizations. I am also responsible for facilitating communication between patient and care teams and providing culturally appropriate health education and self-management support. Additionally, CHW will collaborate within a team-based care delivery model to improve the health and lives of our community members.

Job Responsibilities:

• 1) CHW will develop the drive and determination to learn and grow in the CHW role. I bring positive engagement to daily interactions with patients, families, and the medical team. I am willing to expand my knowledge, abilities, and resilience in the CHW role.
• 2) Target and outreach to a specific population of patients, including home and/or community visits as needed. Act as key point person between patients and providers of healthcare and social services.
• 3) Effectively works with people from culturally diverse backgrounds, including translators, in reducing cultural and socio-economic barriers between clients and institutions.
• 4) Assist with medication adherence, reminding patients about upcoming appointments, arranging transportation or other community services patients may need.
• 5) Act as a key contact person within the clinic for enrollment of new members and educate patients on all aspects of the healthcare delivery system.
• 6) Assist in identifying and utilizing community resources using an approved community resource database and demonstrate the use of applicable EMR systems. Assist in scheduling and accompanying patients to appointments as needed and assisting with the completion of applications for programs for which they may be eligible.
• 7) Communicates between providers and clinical team; work collaboratively and effectively within a multidisciplinary team.
• 8) Build and maintain positive working relationships with the clients, providers, supervisors, and all staff.
• 9) Continuously expand knowledge and understanding of community resources and services, public health prevention, and evidence-based intervention programs provided.
• 10) Effectively utilizes and documents all activities within the EMR and community service plans, resulting in appropriate data collection tools in a clear and concise manner.
• 11) Complete Care Needs Screenings and other applicable screenings to assess the patient's needs and provide appropriate referrals. Coach patients in the effective management of their chronic conditions and self-care.
• 12) Implement culturally and linguistically tailored educational and support activities.
• 13) Collaborates with the care team to track, monitor, and report on specified disease-related and patient tracking measures.

Minimally Required Education:

High Schoo/ GED Enrolled or willingness to enroll in CHW certification program -Preferred Experience Some exposure to working in a community setting

Required Licensures/Certifications:

Reliable transportation and MA Drivers license are required. Education: GED or HiSET (Required) Certifications: Certified Community Health Worker - State of MassachusettsState of MassachusettsState of Massachusetts, Driver License - OtherOtherOther

Compensation Note:

The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum - Midpoint - Maximum $19.29 - $25.47 - $34.33

Equal Employment Opportunity Employer:

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

About Baystate Health:

Baystate Health is a not-for-profit, integrated healthcare system with hospitals, physician practices, a health plan and more serving over 800,000 people throughout western New England. Baystate Health is the safety net provider in Western Massachusetts. With roots dating to the founding of Springfield Hospital in 1883, Baystate Health has been providing high-quality, compassionate and accessible care in the Pioneer Valley for more than 140 years and continues to be a pillar of its community - rooted here, serving here, and helping generations thrive here. With a focus on advancing health for all, Baystate is not only a keystone of the region, it is a national leader in health care. Learn more at BaystateHealth.Org The ever-growing health system includes six Massachusetts hospitals: Baystate Medical Center in Springfield Baystate Children’s Hospital (located at Baystate Medical Center) Baystate Franklin Medical Center in Greenfield Baystate Wing Hospital in Palmer Baystate Noble Hospital in Westfield Baystate Mercy Hospital in Springfield