Community Health Worker

• Manage low risk referrals defined by care management program (Medical Social Work) & collaborate with social worker on action plan
• Develop trusting relationship with patients by providing support and advocacy to help achieve health goals
• Meet with patients in patient centered and patient preferred location (e.g., center, facility, home, community setting)
• Promote goal setting with patients enrolled in care management
• Drive engagement with high risk individuals (e.g., completed specialty appointments, adherence to Post discharge visits) may include accompaniment to appointments
• Assist completion of applications to access eligible benefits
• Wellness checks in home, participate in remote monitoring program education on individuals with specific health conditions
• Provide health screenings, referrals and information
• Deliver health education presentations
• Facilitate communication between all identified parties by the patient involved in care (e.g., family members, care givers, medical providers, community-based organizations)
• Document interactions with patients in medical record
• Other duties, as assigned

• A problem-solving orientation and a flexible and positive attitude
• Preferred 1 year of experience in healthcare, community-based, or social work environment
• Experience utilizing electronic medical record systems
• Knowledge of community resources and resource navigation
• Experience working on a multidisciplinary team preferred
• Proficient PC skills
• Fluency in language that is commonly spoken in the community is necessary. Most often this will include Bilingual English/Spanish
• Travel may be required
• US Work Authorization is required
• Someone who embodies being 'Oaky'

Experience working on a multidisciplinary team preferred

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility