Job Functions
· Develop a wholistic view of patient needs related to Social Determinants of Health
· Identify existing barriers to engagement with necessary resources and supports
· Provide education around maintenance of chronic health conditions, as well as available options for behavioral care and social support
· Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems
· Initiate care planning and subsequent action steps for high-risk members, coordinating with interdisciplinary team
· Supporting patients’ self-determination, motivate patients to meet the health goals they have identified
· Conduct Transitions of Care for Observation stays
· Refer patient to necessary services and supports
o This field may include but is not limited to: assistance with transportation, food insecurity, navigation of and application for benefits including, Medicaid, HCBS, working to reduce costs associated with prescription medications, organizing schedules of follow up appointments, alleviating social isolation
· Perform all other duties and responsibilities as required
Organizational Responsibilities
· Participate in interdisciplinary review of and coordination around complex patients
· Maintain patient confidentiality in accordance with HIPAA
· Document patient encounters in medical record system in a timely manner
· Follow general policies related to fire safety, infection control and attendance
Use your skills to make an impact
Required Qualifications
· High School Diploma or equivalent
· Community Health Worker certification, or willingness to complete within one year
· Minimum of 2 years of experience working in human services and navigating community-based resources
Preferred Qualifications
· Bachelor’s Degree in applicable discipline
· Familiarity with state Medicaid guidelines and application processes
· Experience working with patients with behavioral health conditions and substance use disorders
· Prior experience conducting home visits and knowledge of field safety practices
· Training as an LPN or LVN
· Training as an EMT or paramedic
· Bilingual in English/Spanish with the ability to speak, read and write in both languages without limitations and assistance
Skills/Abilities/Competencies Required
· Ability to multi-task in a fast-paced work environment
· Flexibility to fluidly transition and adjust in an evolving role
· Excellent organizational skills
· Advanced oral and written communication skills
· Strong interpersonal and relationship building skills
· Compassion and desire to advocate for patient needs
· Critical thinking and problem-solving capabilities
Working Conditions
This role has a mobile presence, involving travel to patients’ homes, treatment facilities and community-based settings, and assigned clinics to facilitate connections.
Workstyle: Combination in clinic and field, local travel to meet with members
Location: Must reside in Columbia, SC metro
Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs.
Scheduled Weekly Hours40
Pay Range: The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$53,700 – $72,600 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
