Field-Based CHW: Bilingual Care Coordinator

Asian American Center of Frederick; Frederick (MD); On-site; USD 48,000 - 52,000; Full time

Benefits offered by this job

401(k)

Health Insurance

Vision Insurance

Paid Time-Off

Sick and Safe Leave

Paid Holidays

Job summary

Asian American Center of Frederick is seeking a Community Health Worker, Level 2, to provide intensive care coordination for high-risk adults in Frederick, MD. The role blends in-home visits, risk stratification, and referrals to ensure continuity of care across medical and social services.

You will conduct multilingual intake, engage with diverse communities, document outcomes in Salesforce, and collaborate with the RN Care Coordinator to support Chronic Care Management when appropriate.

Qualifications

• Maryland Department of Health CHW certification; AACF can support certification during onboarding.
• Bilingual; from or closely connected to the communities served.
• Two or more years of CHW, home-visiting, or comparable experience preferred.
• Strong trust-building, motivational, and de-escalation skills; comfortable working in participants’ homes.
• Reliable transportation and a valid driver’s license.

Responsibilities

• Receive and respond to hospital referrals from theED or inpatient discharge; supplement with outreach.
• Complete comprehensive intake, SDOH screening, and risk stratification in Salesforce.
• Conduct risk-based home visits weekly for high-risk participants and document observations.
• Link participants to a primary care medical home.
• Coordinate and track closed-loop referrals for transportation, food, insurance, housing, language access.
• Document every contact, referral, and outcome in Salesforce; protect privacy.

Skills

CHW certification

Bilingual

Community health

Tools

Salesforce

Job description

Asian American Center of Frederick is seeking a Community Health Worker, Level 2, to provide intensive care coordination for high-risk adults in Frederick, MD. The role blends in-home visits, risk stratification, and referrals to ensure continuity of care across medical and social services.

You will conduct multilingual intake, engage with diverse communities, document outcomes in Salesforce, and collaborate with the RN Care Coordinator to support Chronic Care Management when appropriate.