Community Health Worker - Medicaid

Highmark Health; Pennsylvania; Hybrid; USD 29,000 - 41,000; Full time

Job summary

Highmark Health seeks a Community Health Worker to serve as a liaison among members, providers, and community resources. The role includes face-to-face and remote outreach to improve health outcomes and close care gaps within a designated population.

The position emphasizes health literacy, navigation assistance, and collaboration with care management to extend services beyond the scope of practice. Travel up to 75% is required.

Qualifications

• Required High School/GED.
• 1 year of health care related customer service experience.
• 1 year of Community Health Worker experience.
• Certified Community Health Worker (CCHW) - PA Certification within 12 months of start date.

Responsibilities

• Initiate outreach face-to-face and telephonically for preventive health and care gaps.
• Educate members on preventive health services and make referrals to resources.
• Coordinate access to preventive services and address health-related social needs.
• Develop rapport with members and community partners to empower health decisions.
• Collaborate with Head Start, WIC, community centers, and shelters to assist members.

Skills

Customer service principles

Team collaboration

Problem solving

Multitasking

Communication skills

Cultural competency

Empathy and patience

Education

High School Diploma/GED

Job description

Company : Highmark Inc. Job Description : JOB SUMMARY This job serves as a liaison and mediator between members, providers, community -based organizations, and the health plan. Works independently in the community, engaging members within a specific target population as determined by the Managed Care Organization. Works face-to-face and telephonically with members to provide basic health literacy, linkage to community resources, and assistance navigating the healthcare system. The Community Health Worker brings education and support to members in the community and serves as a healthcare advocate for members. This role will outreach and engage members to improve health outcomes, close care gaps and improve overall wellness. Community Health Workers will develop partnerships with local community based organizations and providers to support the needs of the members as well as the community. The incumbent works closely with the care management department and other internal team members to refer members for additional support and education beyond this role’s scope of practice.

ESSENTIAL RESPONSIBILITIES

• Initiate outreach efforts, both face-to-face and telephonically, related to targeted preventive health, care gaps, maternity, care transitions, health related social needs and chronic condition initiatives.
• Educate members on the importance of targeted preventive health services, assess opportunities for care management intervention, and make appropriate referrals, including referrals to community resources as needed.
• Contact member(s), providers, and community agencies to coordinate access to preventive health services and/or assistance to address health-related social needs.
• Develop a rapport with members, community-based organizations and provider partners to establish a supportive relationship which empowers members to take an active role in their health and wellness.
• Collaborate with human services providers such as Head Start Programs, WIC, community centers, and homeless shelters, in the identification and outreach to members in need of services.
• Contribute to the development and preparation of educational materials for members and providers.
• Provide summary and outcomes of outreach attempts and community education to management and peers.
• Participate in the development of programs that are effective, measurable and innovative, with a special emphasis on reaching at risk members.
• Conduct SDOH assessments as needed and assist with scheduling appointments, addressing social health barriers, and answering questions.
• Understand the Organization's lines of business and benefits for members in order to provide accurate and current information to member.
• Represent the company at community events, including events sponsored by community partners.
• Other duties as assigned or requested.

EXPERIENCE

• Required 1 year of experience in a health care related customer service or marketing environment that would demonstrate the ability to positively impact on the engagement of members in the organization's condition and case management programs
• 1 year of Community Health Worker experience or related field
• Preferred Basic medical terminology background
• Experience with the targeted community or population

SKILLS

• Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services
• The ability to interact well with peers, supervisors and customers and work as a team member
• Ability to solve problems independently and creatively and be proactive, self-directed, assertive and creative in problem solving and system planning
• Ability to handle many tasks simultaneously and respond to customers and their issues promptly
• Possess good written and oral communication skills
• Have an appreciation of cultural diversity and sensitivity towards the Medicaid population with demonstrated expertise in topics related to cultural competency including working with members with limited English proficiency.
• Be aware of issues members face related to healthcare including transportation, childcare, lack of knowledge concerning preventive health, distrust of the system as well as other personal, social, financial barriers
• Must demonstrate patience and empathy when interacting with members and all internal/external customers

EDUCATION

• Required High School/GED
• Preferred None

LICENSES or CERTIFICATIONS

• Required Certified Community Health Worker (CCHW) - PA Certification Board within 12 months of start date.
• Preferred None

Language (Other than English): None

Travel Required: 50% - 75%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type Office-Based or Remote Position

Physical work site required

Pay Range Minimum: $20.72 Pay Range Maximum: $30.12 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. California Consumer Privacy Act Employees, Contractors, and Applicants Notice Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.