Community Health Worker Behavioral Health

Serve as a liaison between health and social service community to facilitate access to services and improve the quality and cultural competence of service delivery. Build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. Improve Missourian’s health by providing a connection between health systems and community resources, as well as education on how to reduce behavioral health risk factors.

This is a Full-time, benefit eligible position. The schedule is Monday - Friday 8 : 00am - 5 : 00pm.

ESSENTIAL FUNCTIONS – JOB SPECIFIC

• Facilitate appointments for patients by arranging, coordinating, and facilitating transportation resources
• Follow up on appointments or instructions from the healthcare team by making home visits, meeting the participant in a community setting, and / or phone communication
• Communicate with Primary Care team about barriers to self-management noted during visits
• Promotes wellness by providing culturally appropriate health information and education to patients
• Encourage patients to make steps toward promoting their health and managing their diseases or conditions
• Advance patient’s health literacy related to their condition
• Assist with medication management and adherence through the direction of the primary healthcare team
• Assist in identifying and obtaining clinical, social, and / or community services and resources for patients
• Assist with post-hospitalization or visits by attempting to locate patients that providers were unable to reach
• Communicate with patients, caregivers, and families to assist in meeting patient goals and cultural practices
• Communicates with patients on a scheduled basis both in person and via phone
• Follow up with the team on referrals sent to other providers or social services and follow up with patients on outcomes and next step
• Assists patients in navigating the MO HealthNet, Social Services, and community partnerships systems
• Build relationships and interact with community partnerships, health, and social service providers
• Provides a bridge between the Primary Care and FACT Community Partnership, helping to bridge social determinants of health impacting patients’ health and well-being
• Participate in Primary Care team meetings
• Document in the electronic health record appropriately and in a timely manner
• Meet care coordination requirements as outlined by the MO Department of Social Services and MO HealthNet Division Primary Care Health Home initiative
• Seeks appropriate professional development opportunities
• Attains all agreed-to goals and objectives within specified time frames, as part of the Clinic’s overall mission
• Responsibly follows the Clinic Exposure Control Plans for bloodborne and airborne pathogens, and transmissible conditions
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment
• Promotes effective working relations and work effectively as part of a team to facilitate the Clinic’s ability to meet its goals and objectives
• Train and implement the PRAPARE assessment
• Other duties as assigned