NHC Position Type
Social Determinant of Health – the member will conduct screenings with our patient base and community members for Social Determinants of Health (SDOH). Members will assess screener outcomes and make internal & external referrals linking individuals to services which will support in addressing SDOH identified needs.
BHC Referrals – The member will support the behavioral health team in identifying instances of depression, dementia and partner or elder abuse in conducing SDOH assessment and intakes and refer those patients to our behavioral health consultants.
Food Insecurities - Member will assess food insecurity in patients and connect them with appropriate resources like on-site food pantry, meals on wheels, manna and other food resources. Member will also assist in upkeep with onsite food pantry. Additionally, member will assess patients over 50+ for eligibility and complete appropriate applications for SNAP benefits.
Insurance Navigation – Members will also be trained on the PA marketplace program, Pennie, which will help them assist community, members in the navigation of alternative health coverage options.
Legal Referrals and Clinics– Member will educate patients on “spend down” practices and burial insurance for those who live on a fixed income.
Practice Transformation - The member will have an opportunity to work with our HIV provider team, Operations Manager and Quality Manager to help develop and implement increased and/or improve our services to the HIV positive assessment for our Black and Latinx LGBTQIA+ patients. They will serve as an advocate in assisting patients with navigation of community resources and will aid in the implementation of a network wide practice transformation community needs assessment. The member will actively participate in monthly Practice Transformation meetings and HIV team meetings.
Women’s health- FPCN is in partnership with Fox Chase Cancer Center in conducting breast cancer screenings to our high-risk community members and patients. Events take place one per quarter, and the member will have the opportunity to work with our Care Manager to support this community health initiative by conducting outreach, performing reminder calls and assisting on the day of with team support as appropriate.
The member will provide education and advocacy to Abbottsford Falls patients ages 18 and above ,and the surrounding community in order to improve access to health services at the Abbottsford Falls health center and beyond. Specifically, the member will assist in initiatives to help patients identify barriers that may exists to health care engagement through the delivery of Social Determinant of Health Screenings and linkage to relevant support supervises to address those barriers.
Alternately, the member will support the FPCN shared services department in conducing work not assigned to staff, however beneficial to both the primary care department, agency quality assurance initiatives and specialized health outcome projects where support is needed.
Major Duties and Responsibilities
- Screening patients for health concerns and eligibility
- Attending meetings and patient huddles
- Conducting phone outreach as assigned by leadership
- Assisting in care coordination and resource referrals
- Conducting outreach to patients via phone/letters