NHC Position Type
MNHC serves low-income, immigrant people living in San Francisco and San Mateo counties. The majority of patients are below 200% of the Federal poverty level and many are at 100% FPL. The primary role of this position is to help improve the quality of care of patients with chronic conditions (diabetes, hypertension, depression, etc.) by conducting routine panel management and linking MNHC patients to necessary care. Duties include conducting outreach and timely follow-up with patients to schedule and complete identified services, scheduling patients for Initial Health Assessment appointments, identifying and documenting patients’ linguistic needs, learning styles preferences, transportation needs, etc. and communicating with members of the Care Team, when warranted. Member will provide health coaching to reduce obesity in children. Member will outreach to seniors living at home to understand and communicate back to the Care Teams their needs and challenges.
The purpose is to improve their quality of life through clinical interventions and support services that address the Social Determinants of Health. The Member will collaborate with the Care Team to address the Social Determinants of Health, such as housing conditions, access to healthy living situations, gentrification of the City of San Francisco, etc. by linking patients to other social service organizations that specialize in addressing these structural barriers to healthy living.
Major Duties and Responsibilities
- screening patients for health concerns and eligibility
- providing brief health education to patients
- tracking, enrolling, and surveying patients for improvement
- conducting phone outreach as assigned by leadership
- tracking referrals and closing the referral loop
- conducting outreach to patients via phone/letters
- linking patients to care by scheduling appointments
- developing assessment tools to track patient improvement
Characteristics of an Ideal Candidate
- Comfortable with diversity
- Proficient computer and data entry skills (e.g., Microsoft Excel)
- Multi-tasker; ability to balance
- Good communication skills
- Takes initiative
- Comfortable in fast-paced environment
- Organized; sound organizational skills
- Good customer service
- Good telephone skills
- Speaks language(s) spoken by patient populations (Fluent/Advanced Spanish speaker)
- Start projects independently
Knowledge Required for the Position
- 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 in terms of project objectives and basic priorities and is available for consultation in resolving controversial issues.
- Completed projects are reviewed very generally to determine that objectives have been met and are in compliance with policies and regulations.
Member must use considerable judgment in adapting current or developing new guidance.
- Member has to develop, analyze, or evaluate information before the service position can progress.
- The Member must develop new techniques, methods, or approaches to complete service position assignments.
Purpose and Impact of Service Position Assignments
- Member provides timely services of a personal nature to others.
Nature of Contacts
Purpose of Contacts
also to provide information
Provide documentation of a TB test and certain immunizations (including COVID-19) for work in clinical areas.
Language Proficiency Requirements
- Language proficiency (bilingual in Spanish and English)
- Fluent/Advanced-level Spanish-speaking skills