Job Information
Fenway Health High-Acuity Community Health Worker in Cambridge, Massachusetts
High-Acuity Community Health Worker
Cambridge, MA (http://maps.google.com/maps?q=359+Green+St+Cambridge+MA+USA+02139) • Prevention
Job Type
Full-time
Description
Function:
Under the general supervision of the Care Coordination Nurse Manager and Administrative Manager, High Acuity Community Health Worker Program, provides case management, health navigation services, and coordinates referrals to community resources to people living with HIV/AIDS (PLWHA) who require enhanced care to maintain viral suppression, engagement in care and successfully manage social determinants of health.
Representative Duties:
Provides case management services to PLWHA patients with high level of need and poor medical compliance:
Provides services to patients who have poor medical compliance, uncontrolled HIV viral load, or who otherwise are identified as high risk.
Forms productive, empathic working relationships with assigned patients on their caseload
Screens eligibility and reviews medical, mental health and social history of patients in need of intensive case management services, identifies needs, and refers patients as appropriate in a timely, courteous manner. Referrals may include need for further assessment/evaluation by licensed clinicians or review by a supervisor.
Provides high level of support to ensure barriers to poor medical and medication compliance are mitigated
Provides information to patients about available community resources and assists patients to determine eligibility and obtain services
Provides on-going support to patients as appropriate and conducts outreach to help retain patients in care or to encourage patients to utilize additional necessary services
Links medical patients when appropriate to mental health and substance abuse services
Interacts with patients in community settings (home visits, community locations, hospitals, other program sites)
Meets established service delivery targets
Adheres to NASW Code of Ethics
Collaborates with other agencies:
Develops and maintains resource listings appropriate for Fenway Health patients
Participates in community councils, boards and groups as appropriate to further departmental objectives
Works with Medicaid, Medicare, Welfare, Social Security, housing, educational, day care and other institutions to assist clients
Consults with a variety of health center and community staff (Nutritionists, Home Health Aides, Nurses, Behavioral Health staff and Medical staff) about specific clients and general approaches to patient treatment
Performs and completes administrative tasks in a timely and efficient manner:
Completes psychosocial assessments and care plans for newly enrolled patients
Writes case notes for each patient interaction
Collects necessary programmatic documentation and maintain up-to-date patient files and charts
Assists patients with applications for enrollment in entitlement programs
Assists medical teams with case management administrative tasks
Participates in staff and team meetings and conferences
Participates in professional activities to maintain professional standing
Participates in program reporting and accountability as required by funding agencies
Meets agency participatory expectations:
Suggests and participates in continuing quality improvement efforts
Adheres to all agency and departmental policies and procedures
Participates in quality assessment and improvement activities as requested
Adheres to the highest principles of patient and client confidentiality
Adheres to established safety policies, procedures and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
Attends all required meetings, in-services and professional trainings
Attends all regularly scheduled research meetings, trainings, forums and pertinent FCH staff meetings
Maintains professional competence necessary to perform job responsibilities; maintains and provides agency with records of continuing education activities
Serves on agency committees and in professional organizations when requested
Performs related duties as required
Requirements
Requires a Bachelor’s Degree
Relevant experience may be substituted for educational requirement
Ability to work harmoniously and effectively with colleagues, patients, clients and vendors across the spectrum of diversity, including but not limited to race, ethnicity, color, gender identity, sexual orientation, age, socio-economic status, national origin and immigrant status, religious or spiritual identity, disability (physical, mental, emotional and developmental), veteran status, and/or limited English proficiency.
Willingness to contribute towards Fenway’s efforts in becoming an anti-racist organization and promoting a culture dedicated to ongoing development in service of humility, equity, diversity, inclusion, and belonging, where differences are acknowledged and valued.
Preferred Qualifications:
Preferred Qualifications
Spanish speaking strongly preferred
Experience with LGBTQIA population preferred
Prior case management experience in a medical or community setting and experience working with people who have HIV preferred
Excellent interpersonal skills and ability to be an effective team member, while working frequently off-site
Flexibility, adaptability, independence, and ability to multitask required
Experience working with an ethnically, culturally and racially diverse work staff preferred
Physical Requirements:
Ability to meet the following physical requirements with or without reasonable accommodations:
Sit at a computer station for extended periods of time
Ability to keyboard for extended periods of time
Ability to make community visits, travel regularly, and work in non-office settings
Salary Description
$24.62 - 25.64 per hour/48,000-50,000 per year