Job Summary
The Community Health Worker (CHW) specializing in Chronic Care Management (CCM) will support the patient who has at least one chronic disease (for example heart failure, hypertension, COPD, diabetes). Service provision will vary depending on the individual needs and may be performed in a clinic, facility, the community, or in the patient's home.
The CHW will develop relationships with the patient, provide education and support in the form of risk factor reduction and preventive care, assist with care transitions, serve as a liaison to connect with other care teams and community resources and serve as a patient advocate for the outpatient or inpatient setting. The CHW performs a wide range of tasks to assist clients in gaining, regaining, or maintaining healthy life skills under the supervision of a provider or other qualified health care professional.
The CHW will receive 30-hours of in-house tailored training to include Motivational Interviewing and Chronic Disease Management training such as heart failure, hypertension, COPD, diabetes, and kidney disease (20 hours). Training proficiency will be demonstrated using 50% e-Learning and 50% real-life application under supervision.
The CHW will provide administrative duties such as scheduling, document in medical record, and data abstraction. they will make client phone calls, telehealth calls or in-person visits and oversee remote patient monitoring under the direction of the qualified health care professional team. They will assist the nursing and program director as needed and other duties as assigned.
The CHW will be supervised by the program director and the Chronic Care nursing team. Performs other duties as assigned.
Minimum Job Requirements
- High School Diploma or its equivalent.
- Valid Indiana driver's license.
- Dependable transportation.
Preferred Job Requirements
- Post high school certification.
- Associates degree.
Skills / Knowledge / Abilities
- Knowledge of healthcare policies and governmental regulations pertinent to chronic care management and the community health worker.
- Sufficient knowledge to observe and report changes in client condition.
- Culturally competent.
- Excellent communication skills to communicate effectively and tactfully with patients, as a representative of Marion Health.
- Interpersonal skills necessary to carry out duties independently and in a professional manner.
- Highly developed computer skills to include proficiency with Microsoft Office (Word, Exell and email) and the ability to learn and proficiently perform computer applications related to operations and job function.
- Highly developed computer skills to include proficiency with Microsoft Office (Word, Excel and email) and the ability to learn and proficiently perform computer applications related to operations and job function.
- Ability to be discreet and protect the integrity of any confidential matter or information encountered during the performance of job duties.
Working Conditions
- Typical clinical environment with prolonged sitting and occasional standing and walking.
- Work may be subject to interruptions.
- Works with highly confidential information which may be proprietary or protected health information.
- Driving to patient homes and home encounters with patients.
- May attend special functions and meetings at various locations within the community.
Physical and Mental Activities, Tools and Equipment
- Uses computer and standard office equipment.
- Uses own vehicle to visit patients.
- Lifting, pushing, pulling, walking, sitting, reaching, bending, kneeling or stooping to perfom duties in a safe manner.
Equal Opportunity Employer
Marion Health is a smoke-free environment.