Community Health Worker, Care Coordination & Outreach
Overview
As a Community Health Worker at CCNC, you will own community outreach and education, completing Health Risk screenings and initiating new referrals to Care Management. You will partner with primary care teams to develop whole-person plans of care, connecting members to local resources and improving health equity across North Carolina. You will navigate multiple EHR systems, document in the care management platform, and advocate directly for members in their communities. This role stands out for its hybrid environment, blending community, clinic, and home settings, with travel across the state using a personal vehicle.
What You'll Do9
- 1Drive member engagement by conducting community outreach and education, focusing on members out of care and enhancing retention and self-management.
- 2Complete Health Risk and Social Determinants of Health screenings to identify needs and connect members to appropriate resources.
- 3Initiate and document all referrals from various sources into the care management documentation platform, ensuring accurate tracking.
- 4Navigate EHR systems (e.g., Epic, Cerner) to obtain and upload member data, verifying eligibility and demographic information.
- 5Coordinate care and advocate for members, providing culturally appropriate health education and social support to overcome barriers.
- 6Assist members with accessing and coordinating resources, including state and federal benefits, and navigating the healthcare system.
- 7Collaborate with the care team to design and implement systems that ensure members have access to knowledge and support.
- 8Travel within the region and state using a personal vehicle to meet members in their communities, clinics, or homes.
- 9Attend department and corporate meetings, local and regional trainings, and other events as required, reporting any issues promptly.
Requirements10
- 12-4 years minimum experience in a human services or health care setting, with demonstrated knowledge of targeted communities.
- 2High school diploma or GED required; 2- or 4-year degree in a health-related field preferred.
- 3Bilingual in English and Spanish preferred.
- 4Valid U.S. driver's license with current auto liability insurance.
- 5Knowledge of and experience working in patient or clinical data systems, including EHR platforms.
- 6Proficiency with MS Office and internet-based tools; computer skills required.
- 7Knowledge of state and federal benefits systems.
- 8Excellent oral and written communication skills, including Motivational Interviewing and teach-back methods.
- 9Sensitivity to cultural diversity, language barriers, and health literacy levels.
- 10Ability to adapt to change and shift strategies as needed.
Salary Insight
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