Social Health Initiatives Program Manager

Job Description

At Virginia Garcia Memorial Health Center, we honor all members of our community and acknowledge the dignity of each person we serve. Our purpose is to provide high quality, comprehensive primary health care to the communities of Washington and Yamhill counties with a special emphasis on migrant and seasonal farm workers and a view to removing barriers to health care. We strive to provide an environment that welcomes and values the people we employ and serve.

If you are unsure whether you meet all the required qualifications for this role but are interested and passionate about this potential position, we encourage you to apply.

Job Summary: The Program Manager for Social Health Initiatives (PM-SHI) provides program development and system support for Navigators and Community Health Workers across all service lines and programs including medical, dental, SBHC, and mobile programs. This role will ensure that social health initiatives are integrated across services and that vulnerable populations have access to necessary resources, improving overall health outcomes. The position acts as a central point of contact and communication with all departments to address workflows, systems, and process improvement for collection and tracking of social determinants of health (SDOH) and health-related social needs (HRSN) within our community. The program manager works closely with Operations leaders, Navigators/CHWs and site and program leaders to operationalize system changes and workflows and exercises oversight and accountability for the collection and reporting of SDOH and oversight and tracking for the HRSN benefit including communication with OHP and DMAP administrators and meeting HRSN and SDOH metrics for the coordinated care organizations (CCOs) and Oregon Health Authority (OHA).

The PM-SHI acts as part of the Operations leadership team and may attend Tier 3 huddle and some Operations leadership meetings. The position does not supervise staff. Travel is required.

This position is grant funded through April 30th, 2026 and may continue depending on funding and successful administration of the HRSN benefit.

Essential Duties And Responsibilities

• Under the direction of senior leadership, develop systems that support clinic navigators, community health workers, and clinical staff in identifying and addressing the social drivers and health related social needs that impact patient access and outcomes.
• Develop and maintain subject matter expertise with the HRSN benefit (including Housing, Food, and Utilities benefits) and provide training for HRSN applications through the CCOs and the OHA. Support Navigator staff in managing and understanding these benefits and developing workflows that support patients and staff.
• Manage the HRSN benefit for VG assigned Open Card patients in accordance with guidance and requirements from the Oregon Health Authority (OHA) and in partnership with Comagine, 211, and Project Access Now.
• Review, reconcile, and verify invoices for all VG assigned Open Card patients receiving the HRSN benefit in collaboration with Finance and Foundation. Ensure compliance with all requirements of the HRSN benefit.
• Provide coordination and leadership for large team of Navigators/Community Health Workers (in conjunction with their supervisors) across all service lines to assure collaboration, ongoing training, development opportunities, consistent workflows, and updated standard work.
• Facilitate monthly Navigator meetings including preparing agenda, documentation of meeting discussion and outcomes, coordination of guest participants, and escalation of issues identified by Navigators to the appropriate tiered huddle or leader.
• Collaborate with Community Wellness Program Manager and Community Outreach Manager to support Navigators and Community Health Workers (CHW) in contributing to comprehensive community wellness and health education programming that aligns with VGMHC’s mission and strategic goals.
• Provide support and resources for Navigators in facilitating, coordinating, and organizing group education or group provider visits in accordance with their training and in consultation with site leadership. These classes or groups may include Tomando Control, Walking with Ease, Baby Days, Centering Pregnancy, or other classes or groups Navigators are trained to facilitate.
• Support Navigators and Community Health Workers in gathering and maintaining the information, resources, and services of community agencies and local and state organizations, acting as a liaison with outside agencies.
• Mentor Clinic Navigators or other staff pursuing Community Health Worker certification (if certified and approved to provide mentorship).
• In conjunction with Navigators and leadership, develop metrics and work with Data and senior leadership to develop dashboard for metric monitoring and reporting.
• Participate in conducting and reviewing community needs assessment and direct the planning and implementation of activities based on the identified needs with a specific focus on social drivers of health and health related social needs.
• Implement VGMHC initiatives and strategic plans for addressing health related social needs and social drivers impacting population health outcomes, including monitoring of key deliverables and sustainability in accordance with health center goals and contractual agreements.
• Collaborate with VG operational leadership, data team, and Foundation grants officers to write and submit reports, including preparing and making presentations on data and program activities to the Board and senior leadership as requested.
• Perform audits of SDOH collection, documentation, and reporting.
• Guide workflow development that supports high-quality, person-centered service delivery in environments that may change daily and are fast-paced, flexible, and dynamic.
• Demonstrate stewardship of VG’s mission, vision, and values within all aspects of the day-to-day work assignments.
• Role model professional practice, leadership, and customer service skills.
• Coordinate and facilitate meetings and represent the program through consistent participation in VGMHC leadership meetings and huddles, escalating issues and disseminating relevant information to staff and leaders.
• Actively engage in VGMHC initiatives, projects and workgroups as assigned.
• Support mobile programs and services for migrant and seasonal agricultural workers, including helping develop health related social services for residents of agricultural camps and seasonal nurseries.
• Investigate complaints and develop appropriate action plans.
• Oversee and ensure adherence to policies and procedures.
• Perform other duties as assigned.
  
  

Program Development & Management

• Design, implement, and manage initiatives that address social determinants of health, including housing, food insecurity, education, transportation, and employment.
• Ensure these programs are aligned with organizational goals and community needs.
  
  

Stakeholder Collaboration

• Build and maintain strong partnerships with community organizations, local governments, healthcare providers, and other key stakeholders to create a cohesive and sustainable network of services for populations with health-related social needs.
  
  

Data Analysis & Reporting

• Collect and analyze data related to social health outcomes and program effectiveness. Provide regular reports to leadership and stakeholders on program progress, impact, and areas for improvement.
  
  

Community Engagement

• Engage with community members and leaders to ensure that programs are responsive to local needs and culturally appropriate. Facilitate focus groups, surveys, and outreach activities to gather community input and feedback.
  
  

Budget And Resource Management

• Oversee program budgets and ensure efficient allocation of resources. Identify funding opportunities and collaborate with grant writers to secure funding for program initiatives.
  
  

Advocacy & Policy Influence

• Advocate for policies and practices that reduce health disparities and promote equitable access to care. Stay up to date on trends, research, and best practices in the field of social determinants of health.
  
  

Training & Capacity Building

• Provide training and support to staff and community partners on addressing social health needs and SDOH. Foster a culture of health equity within the organization and among external partners.
  
  

Evaluation & Continuous Improvement

• Conduct regular evaluations of program outcomes and implement strategies for continuous improvement. Use feedback and evidence-based practices to adapt programs for maximum impact.
  
  

HIPAA Requirements

The Program Manager has access to PHI in the course of carrying out their duties. Applying the minimum necessary standard of HIPAA, the designated record sets to which this employee will have access include: all sections of the medical record, patient demographic information in the practice management system, and incoming records, reports, results, consultations, etc. The Program Manager is required to read the content of these records only to the extent needed to accomplish the assigned task (e.g. filing or disclosure).

Knowledge, Skills And Abilities

• Committed alignment with VGMHC’s mission, vision, and values.
• Bilingual English/Spanish preferred (spoken and written).
• Valid driver’s license, reliable transportation, safe driving record and insurance coverage required.
• Strong commitment to working with people and staff from a wide range of ethnic, economic, cultural, and social backgrounds.
• Excellent interpersonal, oral, non-verbal and written communication skills.
• Proficient with Microsoft Office applications (Word, Excel, PowerPoint, Outlook).
• Knowledge of electronic health record system (OCHIN Epic or Epic) is preferred, and competency is expected to be acquired within an appropriate timeframe.
• Ability to embrace and guide change and innovation.
• Ability to self-manage and effectively manage workload, including good organizational and time management skills, multi-tasking, and setting priorities in an ever-changing environment while maintaining a calm, professional environment.
• Ability to work within a team-centered approach and maintain cooperative relationships with multiple stakeholders.
• Ability to supervise multiple functions and activities and delegate authority and responsibility as appropriate.
• Ability to establish and maintain effective working relationships with a wide variety of people, including employees, patients, community partners, public officials, and the public.
• Ability and willingness to work at multiple locations across the broad VGMHC service area.
• Strong knowledge of health-related social needs and the social factors that influence health outcomes.
• Experience working with diverse populations and an understanding of cultural competency.
• Ability to manage multiple projects and priorities in a fast-paced, dynamic environment.
• Excellent communication, presentation, and interpersonal skills.
• Strong analytical skills with experience using data to inform decision-making and drive program improvements.
  
  

Education And Experience

• Bachelor’s degree in community health education, public health, healthcare administration, or another similar field is preferred.
• Certification as Community Health Worker from the Oregon Health Authority or equivalent certifying body, or ability to obtain within 6 months required.
• Three years’ experience in supervision, program management, coaching, or instruction of adults is strongly preferred - preferably in community health education, community health care, public health, or social services program that included program integrity, quality improvement, and systems development.
• Experience working in Community Health, Federally Qualified Health Centers, Mobile healthcare, Public Health, or with special populations including agricultural workers, people experiencing homelessness, public housing, refugees, indigenous communities, or other historically marginalized populations preferred.
• Additional relevant experience can substitute for the education requirement.
• Experience working in a health care environment strongly preferred
• Experience with developing and managing new programs valued.
• Experience managing a program budget, developing staffing plans/models, preparing for external site visits, and reporting program outcomes desired.
• Experience developing and applying process improvements techniques highly valued.
  
  

Behavioral Competencies

Accountability: Role model VG’s mission, vision, and shared values

Customer-Focus: Listen to the voice of the customer and strive to delight them by exceeding their expectations

Teamwork: If someone needs help, help them

Initiative: Be innovative, apply fresh ideas, and continuously improve how you do your work

Confidentiality: Maintain strict confidentiality and respect the privacy of others

Ethical: Demonstrate integrity, honesty, and stewardship in all encounters at work

Respect: Demonstrate consideration and appreciation for co-workers and patients

Communication: Demonstrate the ability to convey thoughts and ideas as well as understand perspective of others

Physical Requirements

• Standing: up to 100%
• Walking: up to 100%
• Sitting: up to 50%
• Lifting/Carrying: up to 50%
• Physical demanding tasks: Must be able to lift/carry up to 30 lbs.
• May occasionally stoop and bend; will reach frequently.
• May occasionally use step stool
  
  

Working Environment/Physical Hazards

• Work in well-lighted, ventilated environment.
• Potential exposure to drug vapors or particles (e.g., powdered antibiotics that are reconstituted).
• Possible indirect exposure to blood borne Pathogens; expected to observe infection control.
• Possible exposure to potentially hazardous chemicals.
  
  

Immunization

Staff members must meet immunization requirements as stated in VGMHC’s immunization policy and state and federal guidelines.

Job descriptions represent a general outline of the essential and major job duties, functions and qualifications required. They cannot be all-inclusive and comprehensive due to the dynamic nature of work performed to accomplish VGMHC’s Mission.

VGMHC is an Equal Opportunity Employer. No person is unlawfully excluded from consideration for employment because of race, color, religious creed, national origin, ancestry, sex, age, veteran status, marital status, or physical challenges. The policy applies not only to recruitment and hiring practices, but also includes fairness in placement, promotion, transfer, rate of pay, and termination.