Community Health Worker

At Devoted Health, we're on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission. Job Description A bit about this role: Devoted Medical Group was founded on the belief that if we treat each member like we would our loved ones, we can meaningfully improve healthcare experiences and outcomes for some of America's most vulnerable patient populations. The Intensive Home Care (IHC) Program is at the heart of this goal: we are a highly collaborative, multidisciplinary team of physicians, nurse practitioners, case managers, social workers, community health workers, and outreach specialists united by our mission to build a better care delivery system for Devoted's most complex members. Through a mixture of in-home and virtual interventions, we provide whole-person clinical, social and logistical support for patients with complex chronic conditions, frail elders, and patients at high risk of hospital admissions. The Community Health Worker (CHW) is vital to the success of the Intensive Home Care Team, playing a critical role in building trusting patient relationships and empowering patients to live healthy, dignified, independent lives. The CHW's primary responsibilities include front-line patient advocate, community resource connector, care navigator & coordinator, and wellness and life skills coach, described in greater detail below. Patient Advocate & Community Resource Connector Work with the IHC team to screen patients for Social Determinants of Health (SDOH) needs & mobilize appropriate community-based resources. Identify and catalog available community or national resources (i.e., transportation, housing, financial, food, medication discounts, support groups). Perform a mixture of virtual, telephonic & field-based patient outreach, education & engagement visits. Telephonic and in-person patient check-ins. Care Navigator/Coordinator Serve as Intensive Home Care's "Care Traffic Controller," working closely with patients' PCP, specialists, and the IHC team to facilitate and track resolution of clinical orders, such as scheduling appointments, diagnostic testing, DME, Home Health, and medical record needs. Assist Intensive Home Care clinician, case manager, and social worker in reviewing patient panel needs and expediting/prioritizing key tasks such as scheduling follow-up visits and addressing STARs gap. Prepare for, and actively participate in, weekly Intensive Home Care Team Patient Rounds, helping the team to identify high risk patients, resource needs, and next steps. Provide continuous administrative and outreach support for patients transitioning from hospital to home, ensuring a safe, smooth transition that meets HEDIS/STARs evidence-based transition of care requirements. Wellness & Life Skills Coach Reinforce patient education & care plans for acute and chronic conditions through virtual and field-based touchpoints. Assist patients with practical skill development, such as how to use a pill dispenser, arranging community resources like Meals on Wheels, or showing someone how to complete needs-based paperwork. Conduct Fall Risk Assessments in home and provide education to patient on safety concerns identified. Educate & motivate patients' families and caregivers on patient needs to establish a sustainable support system. Attributes to success: You love helping others improve their health and navigate a complex healthcare system with compassion, empathy, and warmth. You are comfortable performing care coordination for a predominantly elderly, complex Medicare population. You are able to ease the stress and anxiety of patients during difficult times. You have a natural ability to successfully communicate and interact with different stakeholders in a patient's life from doctors to pharmacies to nurses to caregivers. You are comfortable working with members over video and phone, but also in-person in their homes. Agility and collaboration are critical to your success - we are a new organization and have a start-up mentality. You are comfortable engaging and learning new technologies including electronic health records and different computer platforms, operating systems and programs (Google Chrome, Google Sheets). You have a passion for supporting the delivery of healthcare that we would want for our own family. You enjoy a fast-paced, high-energy, growing organization. Required skills and experience: Community Health Worker Certification, Certification of Medical Assistant (CMA), Registered Medical Assistant (RMA), or an Associates degree or higher in health sciences or related field and 5+ years' work experience in a healthcare setting. Understanding of the resources in your community and experience working with patients to access these. Two (2) years of clean driving record. Two (2) years of experience in outpatient medical care, with a bonus if you have experience with telehealth or house call visits. The ability to comfortably multi-task: you'll be listening, talking and typing all at the same time. Team player mentality with a can-do attitude. Comfortable working with internal and external stakeholders to advocate for our patients. Desired skills and experience: Geriatric experience or experience caring for an elderly or frail Medicare population. Health insurance experience, particularly Medicare Advantage. Prior experience working with complex patients and/or underserved populations. Salary range: $20-$32/hour Healthcare equality is at the center of Devoted's mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity). Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted's Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.