Community Health Worker

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

The Community Health Worker (CHW) performs telephonic and in-person outreach and assessment of identified populations and provides coordination of community resources and support to Members and Providers across service areas. Identifies, facilitates, coordinates and advocates for Member access to services that enhance healthcare access and delivery by assisting in the coordination of safety net services that provide for basic needs such as education, housing, healthcare, legal, transportation and counseling assistance.

Our Investment in You:

* Full-time remote work

* Competitive salaries

* Excellent benefits

Key Functions/Responsibilities:

* Assesses member needs by conducting interviews and structured assessments using Motivational Interviewing techniques to engage Members and determine non-clinical and social needs and engage them in care management.

* Collects data to assist members in better health management.

* Educates members by providing information on how to obtain resources, basic health information and by sending information packets to Members containing health information relative to the Member's identified conditions.

* Assists members in the completion of applications for community resources such as food stamps, housing, utilities, vocational opportunities, etc.

* Collaborates with Medical or Social CMs, when co-managing or consulting on a member case

* Maintains current knowledge of community resources for referral and linkage to meet Members' needs

* Participates in group meetings to ensure policies, procedures, and work flows are up to date and advises on revisions needed.

* Champions, coaches, and trains members in collaboration with other BMCHP clinical staff

* Facilitates member communication with external partners such as state agencies, community based organizations, clinical vendors, and primary care and specialty practices.

* Meets with members in various community settings and may accompany members to health care related appointments to enhance compliance to and comprehension of plan of care.

* Schedules primary care provider appointments for members, where able; and assists members in scheduling appointments.

* Completes documentation in the medical management information system in a timely manner and in keeping with contractual requirements, internal policy and accreditation standards.

* Complies with established metrics for performance, and work flow standards and utilizes other department specific tracking tools.

* Individualizes communication style with members to accommodate language and cultural barriers

* Creates and triages cases to clinical staff, other departments, contracted vendors and providers, as appropriate. .

* Adheres to departmental/organizational policies and procedures and maintains HIPPA standards and confidentiality of protected health information.

* Educates members on the importance of completing preventative care services assists members in accessing appointments for these services.

* Other duties as assigned

Supervision Exercised:

* n/a

Supervision Received:

* Weekly and on-going from Manager of Care Management

Qualifications:

Education Required:

* Associate's degree in Healthcare related field or equivalent combination of education and relevant work experience.

* Completion of Community Health Worker training program/certification program or equivalent work experience.

Experience Required:

* At least 2 years of experience as a Community Health Worker or in a similar position in health care environment.

Preferred/Desirable:

* Knowledge and experience in preventative care guidelines.

* Experience with care coordination or case/care management.

* Prior customer service experience.

* Bilingual skills

* Intermediate Microsoft Office skills

Certification or Conditions of Employment:

* Pre-employment background check

* Certified Community Health Worker or equivalent preferred

* Ability to conduct face-to-face appointments with members

Competencies, Skills, and Attributes:

* Motivational Interviewing skills

* Strong oral and written communication skills

* Ability to effectively collaborate with health care providers and all members of the interdisciplinary team

* Ability to work independently and collaboratively with others.

* Strong organizational and time management skills

* Ability to work in a fast paced environment and multi task

* Knowledge of medical terminology

* Knowledge of community resources

Working Conditions and Physical Effort:

* Regular and reliable attendance is an essential function of the position

* Work is generally performed in the field with some home/corporate office work. Position is eligible for telework

* Regular and reliable transportation is required

* No or very limited physical effort required.

* No or very limited exposure to physical risk

* Regular and reliable transportation is required

Compensation Range:

$27.64 - $40.14

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note: This range is based on Boston-area data, and is subject to modification based on geographic location.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees