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Northeast Pennsylvania

Care Coordinator

The CHW will identify individuals factors that influence health outcomes for clients (e.g., food and housing insecurity, transportation issues, social isolation) through interviews, surveys, and safe home visits. They will then collaborate with clients to create personalized plans addressing these needs and health goals. A key function of this role is connecting individuals and families to vital community resources like food banks, housing and transportation assistance, employment support, childcare, and legal aid. The CHW will also provide health information, aid in navigating and enrolling in insurance and public benefits (e.g., SNAP, Medicaid), and provides support to individuals who are communicating with healthcare and social service systems. Ongoing support and follow-up will ensure successful resource connection and progress. Furthermore, the CHW will facilitate communication and collaboration among healthcare team members, including primary care and behavioral health specialists. They will also support patients with medication and treatment adherence and help them articulate their needs to providers, fostering a more integrated care experience for those with both behavioral and physical health concerns.

-Enhancing the organization's value-based program using data and achieving quality recognition.
-Educating and engaging patients on program benefits, preventative care, and proper use of healthcare resources.
-Addressing barriers by identifying issues, developing management plans, and connecting patients with community resources (housing, food, etc.).
-Facilitating communication and coordinating care between patients and providers, ensuring adherence to care plans.
-Maintaining thorough documentation in the EMR, including encounters and reports.
-Providing patient support and advocacy, especially during initial visits.
-Coaching patients in managing chronic conditions and self-care.
-Motivating patients to be active and engaged participants in their health.
-Ensuring patients understand care plans, health center resources (financial assistance, language services, etc.), and payment options.
-Maintaining compliance with safety and organizational standards.
-Building positive relationships with patients, staff, and providers, working to reduce barriers to care.
-Participating in team meetings and extended access hours.
-Understanding insurance dynamics and to enroll patients
-Conducting patient engagement and outreach in addressing factors that influence health outcomes.
-Capturing patient demographic data, particularly barriers to care
 

Team-oriented

Flexible

Detail-oriented

Community engagement/outreach skills

Able to communicate effectively with all individuals

Compassionate

Skill with Microsoft Office or other software for a variety of data processing operations involving a range of problem solving, record keeping, correspondence, and service tracking options.

The supervisor assigns service activities, advises on changes in procedures, and is available for assistance when required

The supervisor assigns service activities in terms of project objectives and basic priorities and is available for consultation in resolving controversial issues.

The service activities are reviewed for accuracy through spot checks, through complaints from customers, and through observation of the member at service.

The member independently plans and carries out the projects and selects the approaches and methods to be used in solving problems

Completed projects are reviewed very generally to determine that objectives have been met and are in compliance with policies and regulations.

Written and oral guides provide specific instructions for doing service

Detailed guidelines exist, including regulations and directives, handbooks, precedents, industry standards, and files of previous projects

Service hours are Monday through Friday 8am-430pm or 830am to 5pm. Please note that member's lunch break does not count towards the member's service hours

Attire is business casual with no jeans, no flip flops, no ill fitting clothing. Member can wear dress pants, slacks, leggings that are dressy. NO yoga pants. No sweatshirts. No T Shirts. Polo type golf shirts, button down shirts, blouses, sweaters are all allowed. No sneakers. Dress type shoes, casual shoes, etc. are permitted

The facts or conditions of the service position are clear cut, predictable, and apply directly to the assignment

The service position assignments vary significantly or often involve unusual circumstances and incomplete or conflicting data

Unusual physical demands involving climbing, lifting, stooping, and reaching, etc.

Unusual service hours, involving evenings, weekends, or long shifts

Personal vehicle required

Special safety regulations or precautions that must be observed

Health screening or service required

Criminal history check requirements beyond those required by National Health Corps

Position offers flexible hours/service formats for members who may need them due to childcare commitments, probation/parole requirements, or other obligations. If so, please describe the parameters of this flexibility.

English

The Wright Center requires criminal history background checks, FBI fingerprinting, a pre-employment physical exam and up to date vaccinations.

Yes