Community Health Worker - Specialty Clinics

Grmc Wvumedicine; Northern (KY); Hybrid; USD 23,000 - 34,000; Full time

Benefits offered by this job

Possible shift differentials

Job summary

SPGC Specialty Physicians of Garrett County, LLC seeks a Community Health Worker to serve as a trusted liaison, conducting in-home and community wellness visits, risk assessments, and resource connections. You will support adherence, care plan goals, and transitions of care while partnering with an interdisciplinary team.

The role emphasizes independent work in community settings, with a focus on social drivers of health and preventive care engagement.

Qualifications

• Capable of independent discretion and decision making in healthcare teamwork.
• Effective oral and written communication with patients and teams.
• Basic computer skills for charting and scheduling.
• Strong interpersonal skills and problem solving abilities.

Responsibilities

• Conducts in-home, clinic-based and community visits to assess needs.
• Supports care plan understanding and follow-up with patients.
• Assists with appointment reminders and follow-up care needs.
• Supports transitions of care after hospital discharge.
• Connects patients to internal and external resources.
• Documents encounters and follow-up activities in the EHR.

Skills

Independent decision making

Oral and written communication

Basic computer skills

Interpersonal skills

Education

High School diploma or equivalent

Valid Driver’s License

Job description

The Community Health Worker serves as a trusted community-based liaison, navigator, and member support resource. This role supports patients and members by conducting in-home and community-based wellness visits, completing health risk assessments and follow-up, identifying barriers to care, connecting individuals to appropriate health care and social needs resources, and reinforcing care plan goals. The Community Health Worker works closely with members of the interdisciplinary care team to support whole-person care. This position helps patients and members navigate the health care system, address social drivers of health, improve engagement in preventive and chronic disease care, support medication adherence, and promote successful transitions of care after hospital or emergency department discharge. This role requires strong communication skills, comfort working independently in the community, the ability to build trust with diverse populations, and sound judgment in identifying and escalating concerns appropriately.

MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE:

• 1. High School diploma or equivalent
• 2. Valid Driver’s License.

PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE:

• 1. Completion of a Community Health Worker, Community Healthcare Worker, Community Health Education Resource Person, or similar curriculum within one year of hire.
• 2. CPR certification.
• 3. Medical Assistant, Certified Nursing Assistant, Patient Care Technician, Health Coach, Peer Support, or other health care/community health-related certification.

EXPERIENCE

• 1. Prior experience in a health care, community health, public health, social service, case management, care coordination, patient navigation, or related setting.
• 2. Experience working directly with patients, members, families, or community members to address barriers to care.
• 3. Experience with electronic health records or other documentation systems.
• 4. Experience supporting patients with chronic conditions, preventive care needs, medication adherence, transitions of care, or social drivers of health.
• 5. Experience conducting outreach, home visits, community-based visits, or field-based work.

CORE DUTIES AND RESPONSIBILITIES

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. Conducts in-home, clinic-based, telephonic, and community-based wellness visits with patients/members as assigned.

• 1. Completes health risk assessments, social needs screenings, and follow-up activities to identify barriers related to health care access, food, housing, transportation, medication access, safety, utilities, and other social drivers of health.
• 2. Provides support, education, and reinforcement to help patients/members understand and follow their individualized care plans.
• 3. Supports medication adherence by providing reminders, identifying barriers to medication access or understanding, and escalating concerns to the appropriate clinical team member.
• 4. Assists patients/members with appointment reminders, follow‑up care needs, preventive screenings, immunizations, routine checkups, and appropriate use of their medical home.
• 5. Facilitates transitions of care after hospital, emergency department, or skilled nursing facility discharge by assisting with outreach, follow‑up needs, appointment coordination, resource connection, and escalation of concerns.
• 6. Connects patients/members to appropriate internal and external resources.
• 7. Helps patients/members access community‑based resources, including food assistance, housing support, transportation resources, utility assistance, financial assistance programs, and other social service supports.
• 8. Assists patients/members with completion of forms, applications, resource referrals, and follow‑up steps needed to access programs or benefits for which they may be eligible.
• 9. Serves as a trusted liaison between patients/members, families, community organizations, health care providers, clinics, and social service agencies.
• 10. Builds positive, supportive relationships with patients/members while promoting engagement, self‑management, and active participation in health and wellness goals.
• 11. Documents all encounters, outreach attempts, assessments, identified needs, interventions, referrals, and follow‑up activities in the appropriate electronic system according to departmental expectations.
• 12. Escalates concerns related to safety, unmet social needs, changes in health status, behavioral health concerns, medication concerns, suspected abuse/neglect, or barriers requiring clinical or social work intervention to the appropriate team member.
• 13. Maintains current knowledge of community resources, health care services, payer resources, internal programs, and referral pathways.
• 14. Works collaboratively and effectively within a team while also demonstrating the ability to work independently in community‑based settings.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 1. Frequent standing, sitting and walking or ability to sit for long period of times.
• 2. Ability to walk moderate distance indoors and outdoors.
• 3. Ability to lift, push, or pull a minimum of 40 pounds.
• 4. Visual acuity(corrected)-keen for both distance and near objects ; Hearing (aid permitted)–must be able to function without use of lip reading.

WORKING ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 1. While performing the duties of this job, the employee is occasionally exposed to moving mechanical parts, airborne particles, body fluids, toxic or caustic chemicals, risk of electrical shock, and risk of radiation. The noise level in the environment is usually moderate. The environment is clinical in nature and also home based and the community as well.
• 2. There may be factors and situations encountered or associated with one’s job or work environment that create potential stress, emotional strain and/or other interpersonal problems.

SKILLS AND ABILITIES

• 1. Capable of independent discretion/decision making, manages stress appropriately and strong organizational and interpersonal skills for working within the healthcare team and with clients.
• 2. Effective oral and written communication.
• 3. Basic Computer skills.
• 4. High level of interpersonal skills, problem solving and strong analytic abilities.

ADDITIONAL JOB DESCRIPTION

Scheduled Weekly Hours: 40

Shift: Exempt/Non-Exempt: United States of America (Non‑Exempt)

Compensation Range: $16.62 - $24.93

Position is eligible for shift differentials based on shift worked and eligible for overtime pay hours over 40 hours per week

Company: SPGC Specialty Physicians of Garrett County, LLC

Cost Center: 8240

SPGC Surgery Address: 255 North Fourth Street Oakland Maryland

Benefit eligible employees classified as at least 0.5 eligible for: Medical, Dental, Vision, Disability Coverage, Tuition Program, Retirement, Paid Time Off, Wellness Program

EQUAL OPPORTUNITY STATEMENTS

Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

The West Virginia University Health System is West Virginia’s largest health system and largest private employer, providing care to communities across West Virginia, Maryland, Ohio, and Pennsylvania. The integrated academic health system includes 25 hospitals and five institutes, with more than 3,500 licensed beds, 4,000 clinicians, 39,000 employees, and $8.5 billion in annual operating revenues. Anchoring the system in Morgantown, West Virginia, are WVU Hospitals, an 880‑bed academic medical center, and the 150‑bed WVU Medicine Golisano Children’s Hospital. Together, the Health System’s hospitals, clinics, and specialty programs provide a comprehensive continuum of care, ranging from community-based primary and specialty services to highly complex, quaternary care and post‑acute care.