Position Summary
Community Health Specialists connect/link patients that have barriers to care, support preventive aspects of health, assists patients in accessing psychosocial and/or health services and support patient empowerment through health education and coaching. Community Health Specialists develop and maintain collaborative relationships with community key stakeholders, gatekeepers and other community organizations, assist patients in navigating health care and social transitions, and support patient empowerment through health education and coaching.

Core Job Responsibilities

• Engage patient assigned or referred for community health specialist in a collaborative on-going relationship to help facilitate their care
• Promote programs and services for families and provide health care and social information that encourages self-management
• Market ACCESS programs and services and empower people to engage in the health programs
• Educate on basic medical illness and diseases.
• Assess patient’s strengths and needs and develop a plan for intervention. Care planning and coordination is done in collaboration with an interdisciplinary team
• Provide ongoing follow-up with patients and/or service providers to determine whether patients have accessed services. Follow-up should be continuous from initial identification through case closure.
• Make home visits and conduct case management activities in community settings as required by program guidelines
• Conduct or co-lead group interventions as required by program guidelines
• Serve as part of the patient’s care team and support health center operations and attainment of organizational metrics
• Establish effective and respectful relationships with patients, families, professionals, payers and other relevant parties
• Assist in developing/maintaining community referral relationships and effectively connecting patients and families to community resources
• Engage in community planning groups and/or meetings to support the social and health care needs
• Using information systems and decision support, maintain a risk-adjusted caseload, and provide direct case management services to address specific issues affecting their health risk or health status
• Complete documentation and data entry as needed to assure optimal patient care and program reporting – track outcomes of outreach efforts
• Participate in evaluating outcomes at the individual level with each patient and at the same time participate in agency-wide evaluative and quality improvement efforts
• Obtain & maintain certifications/licensure/trainings as needed
• Perform other duties assigned

Community Health Specialist job description continued

Requirements/Preferences

• High School diploma required; Bachelor’s degree preferred in a health-related field (social work, psychology, counseling, rehabilitation, gerontology, sociology, or other human service field).
• Minimum one (1) year case management experience or two (2) years of experience in a public or private social service program or health care setting.
• Demonstrated knowledge of working in a community based or public health setting.
• Basic familiarity with medical terminology
• Intermediate proficiency with Microsoft Office products (specifically, Word, Excel, Outlook)

Competencies/Behaviors

• Strong communication abilities; written and verbal
• Customer (patient) service orientation
• Strong attention to details and accuracy
• Ability to work independently as well as within a team
• Ability to effectively manage time and priorities

Working Conditions/Equipment

• Health Center Environment
• Work within the community
• Computer
• Phone/Fax/Copier/Scanner

EMPLOYEE EXPECTATIONS
Following are guidelines of expectations for all employees of this organization. These guidelines are incorporated as part of your job description.

As an employee you are expected to do the following:
➢ Be courteous, friendly, helpful, and supportive. Use a person’s name and use such phrases as “please,” “thank you,” and “may I help you?” whenever appropriate.
➢ Promote team spirit. Work together and cooperate in an effort to promote quality client services and enhance staff relationships. Help fellow staff members perform their work. Share responsibilities. Recognize others’ achievements.
➢ Anticipate and meet client needs. Be observant of and react to individual client needs. Client dignity is of primary importance.
➢ Participate in making quality of work better. Suggest improvements to your supervisor. Help others learn correct procedures. Be open to new ideas and methods.

➢ Maintain current knowledge in your area of skill and expertise and strive to improve your own work.
➢ Report to work on time as scheduled. You should be at your work assignment ready to begin work at scheduled starting times. Observe break times appropriately.
➢ Make efficient use of your time at work. Establish priorities with your supervisor and use your time wisely.
➢ Communicate effectively. Be open, honest, and truthful with yourself and others. Talk to your supervisor. Ask questions. Give your supervisor pertinent information, stating the facts without concealing or exaggerating.
➢ Maintain an appropriate appearance. Make sure clothing is clean and you are neatly groomed. It is important to portray a positive image.
➢ Know the structure, philosophy, and purpose of the organization. Know how you fit into the structure and purpose of the organization. Maintain and promote the philosophy of the organization.

Who We Are

ACCESS is at the forefront of expanding access to affordable, comprehensive healthcare. We understand that we must continually work to evolve our thinking around patient care. As a community health care leader, we know that regardless of all the resources and advancements in medicine today, patient engagement is the most critical element in improving health outcomes. To achieve this outcome, we innovate and develop better practices to improve our care delivery model. To continue successfully down this path, we search for candidates who share our values and goals.

We don’t discriminate for any reason. We welcome talent who believes in our mission, drives the organization forward and cares about the value they bring to an organization.


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