Job Details

Job Posting

Job Location: Sonoma County - SONOMA, CA

Position Type: Full Time

Job Category: Health Care

Essential Duties and Responsibilities:

• Find member populations that are difficult to locate (homeless, severe mental illnesses, substance use, medically underserved, in need of preventive services, etc.)
• Enroll members into programs and services by effectively communicating their value
• Work with members to provide effective and efficient service coordination
• Provide on-site/in-home member assessments for safety risk, health needs, and barriers to care
• Develop service plans and guides with members and providers that include health management goals
• Engage members to achieve health management goals using health coaching, motivational interviewing, and problem solving techniques
• Assist members in overcoming any barriers to meeting health goals and update service plans accordingly
• Assist members in scheduling appointments and accessing community resources
• Arrange for, or directly provide, member transportation to health services appointments
• Accompany members, as indicated, to health services appointments. This may include transporting mothers and their infants to postpartum appointments
• Follow up with members via phone calls, home visits, and visits to other settings where members can be found
• Work with social service agencies to arrange to meet other member needs (housing, food, clothing, financial assistance, etc.)
• Work with facilities to help transition members after discharge to a safe home environment
• Maintain accurate, quality, timely, and consistent documentation in company database of member activities and interventions
• Achieve set goals/KPI's
• Continuously expand knowledge of community resources, services, and programs available to members and build ongoing relationships with these organizations to advocate for members
• Other duties as assigned

What We Offer:

• Competitive salary
• Health, dental, and vision insurance
• Short-term disability insurance
• 401K
• Paid time off
• 9 paid holidays

Job Qualifications:

• Knowledge of community resources within the community to be served
• Able to maintain clear professional boundaries with members and coworkers
• Working knowledge of social and health issues
• Ability to quickly establish trust and build strong relationships
• Highly organized and self-motivated to work independently and manage schedules efficiently
• Sound judgment and the ability to quickly analyze situations
• Ability to establish priorities and meet deadlines
• Ability to problem solve in a proactive, creative manner
• Ability to work independently within a virtual operating environment and as part of a team
• Represent the company with professionalism
• Cultural competency- able to work with diverse groups of community members
• Multi-lingual capabilities preferred, but not required
• Excellent communication skills
• Technologically knowledgeable or experienced in note entry systems, smart phones, and laptops
• Experience providing peer support to patients with complex and multiple chronic conditions and challenging social and mental health conditions (e.g. Community Health Worker, Patient Navigator, In-Home Support Specialist, etc.).
• Training or experience in community health, social determinants of health, and peer counseling.
• Understanding of mental illness and addiction and ability to engage with clients who struggle with these issues at all levels.
• Training and experience in using Motivational Interviewing strongly preferred
• Strong interpersonal and social skills with demonstrated ability to collaborate with a variety of individuals from a wide range of professional and personal backgrounds.
• Knowledge of community-based healthcare and social services systems and the needs of medically underserved populations, and older adults/seniors
• Ability to work with individuals from varied professional background and diverse cultures with multiple chronic conditions.
• Ability to thrive in a complex and rapidly changing environment.
• Ability to build credibility and trust with clients/patients.
• Maintains confidentiality and follows HIPAA standards in safeguarding patient information.
• Good oral and written communication skills.
• Strong organizational skills.
• Able to operate small office equipment, including photocopier, telephone, and personal computer
• Basic knowledge of Microsoft Office.
• Knowledge and/or experience within Home support Services (IHSS) is highly desirable.
• Life experience overcoming the challenges of chronic disease or work experience with people living with complex chronic conditions is highly desirable.
• Experience working with people living with addiction desirable.
• Bilingual (Spanish) required.

Education & Work Experience:

• High School Diploma/GED required
• Bachelor's Degree preferred
• Community Health Worker Certificate preferred
• Minimum of 2 years experience working in health, social, or community services required
• State-based certification may be required

Physical & Other Requirements:

• Must reside in or be very familiar with the language and culture of the community served. There will be daily travel to local geographic regions and, depending on the region, it may require frequent walking
• The CHN will need to pass reference and background checks, submit to a drug test, and have a clean driving record

Candidate Must Possess the Following:

• A valid driver's license
• Access to an insured car