At PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people! We are looking for a Community Health Worker in : Jacksonville, St. Augustine, Duval County,St. Johns Orange Park and Jacksonville Beach! YOU MUST BE FULLY VACCINATED.

The Community Health Worker (CHW) is a full-time experienced community health services professional with responsibility for conducting home based and telephonic visits with patients, assessing community and social support needs of patients/caregivers, and to help with patient action plans. As part of a care team, the CHW reviews history and documentation prior to completing a visit and recommends additional interventions for the patient’s action plan and/or facilitates social work and community support for an interim period based upon need. He/she is field-based with some office duties.

Position Essential Functions:

• Longtime resident of County with great knowledge of resources in the community
• Responds to referrals involving:
• Unmet social needs impacting care and utilization
• Behavioral health issues impacting care and utilization
• Issues concerning possible permanent change in level of care, including residential placement
• Complex family dynamic issues impacting care and utilization
• Social, family, function barriers to care
• Assists patients with organizing their records, making follow-up appointments, filling prescriptions, and accessing needed community-based services
• Identify and Assist with Social Determinants of Health Issues like finding transportation, better housing or food resources, financials
• Provides culturally appropriate health education and support on lifestyle modifications (healthy diet, importance of exercise, stop smoking)
• Completes in-home and telephonic contacts with patients as required
• Documents initial/ongoing assessments and action plans in the electronic health record
• Follow-up on plans of care and action items
• Documents each patient encounter in detail
• Works with other CHWs, local and national to create and maintain a resource book
• Assists with the coordination of care and services with community team members
• Participates in internal and customer-facing clinical case conferences
• Participates in Multidisciplinary Team Meetings
• Collaborates closely with the HBAPC care team on individualized interventions to improve patient self-management and health outcomes, and any community resources
• Communication Skills, knowledge of Motivational Interviewing

Qualifications:

• Bi-Lingual in English/Spanish preferred
• You Must be Currently Vaccinated
• Ability to work weekends and evenings if required
• High school or GED required,
• Associates or bachelors preferred
• Preferred 2 years of experience in health or social services
• Excellent oral and written communication skills & ability to carry out written and oral instructions
• Strong advocacy skills, including the ability to advocate for the patient
• Strong interpersonal and relationship building skills
• Ability to work independently as well as with a team
• Ability to navigate and use an electronic health record for documentation, and working knowledge of computers and ability to document effectively and efficiently in an electronic health record system
• Drivers license requirements: licensed for a minimum of 3 years without restrictions; no DUI or other felony driving conviction in the past 7 years

Job Type: Full-time

Pay: Up to $41,600.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Application Question(s):

• Willing to go into the homes of Members ?
• Are you fully vaccinated? Fully Vaccinated - individuals are considered fully vaccinated 1) two weeks after their second dose in a 2-dose series (such as the Pfizer or Moderna vaccines); 2) two weeks after a single-dose vaccine (such as Johnson & Johnson's Janssen vaccine)

Education:

• High school or equivalent (Preferred)

Experience:

• in health or social services;: 2 years (Preferred)
• Community Outreach: 1 year (Preferred)
• Motivational interviewing: 1 year (Required)

License/Certification:

• Driver's License (Required)
• Current Auto Insurance (Required)

Work Location: On the road

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