Become a part of our caring community and help us put health first
 

Working within an interdisciplinary care integration team (CIT), the Community Health Worker is responsible for proactively engaging patients and serving as the linking role between a patient, their community, and their healthcare ecosystem including PCP and other specialists, and implementing targeted interventions to address barriers to health and increase access to care.  

This role requires outreach strategies to engage patients at least weekly, providing culturally appropriate health education, advocate for needs, facilitate communication between key stakeholders in the patient’s community (e.g., facilitate coordination with local food bank) and health care providers (e.g., coordinate visits, review annual wellness visits, and education materials, and engage people on the complex items healthcare stakeholders are sharing with them to help establish a question list for their next appointment and work with patients to help navigate).

Community Health Workers (CHW) coordinate care across health and social service systems serving as their patient advocate and support including yet not limited to the following:

• Needs Assessment: Assessing the health needs of a community to identify priority areas for intervention.
• Screening and Coordination: Conducting basic health screenings and help coordinate with the appropriate healthcare providers for further evaluation and treatment. 
• Outreach and Home Visits: Conducting community outreach activities, including home visits, to identify individuals and families in need of healthcare services, understand their living situation, and understand what barriers the patient is facing.
• Health Education: Providing culturally appropriate health information and education. Engage patients in material from providers / clinicians to help them understand or formulate questions for their next visit.
• Care Coordination: Facilitate communication between individuals, healthcare providers, and social service agencies to ensure seamless care coordination including facilitation of the coordination in partnership with patients virtually, in home, or on a 3-way call helping patients as needed.
• Advocacy: Advocating for individuals and communities to access necessary healthcare services, addressing barriers including transportation, language, and financial limitations. Includes assisting patients in setting services up and empowering patients/caregivers to support self-management.
• Social Support: Provide emotional support and coaching to individuals navigating complex health situations.
• Community Engagement: encourage and empower patients to build relationships with community leaders and organizations to promote health initiatives and increase community participation (e.g., attend a community center Zumba class with a patient the first time)
• Cultural Competence: Understanding and respecting the cultural differences of the community they serve to effectively communicate and provide culturally sensitive care

Duties and Responsibilities

• Develop a wholistic view of patient needs and facilitate addressing barriers to health
• Identify existing barriers to engagement with necessary resources and supports
• Provide education around maintenance of chronic health conditions, as well as available options for behavioral care and social support
• Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems
• Initiate care planning and subsequent action steps for high-risk members, coordinating with interdisciplinary team
• Facilitate interdisciplinary team rounds in partnership with the care team
• Supporting patients’ self-determination and motivate patients to meet health goals they have identified
• Facilitate and help patients with necessary services and supports
  • This field may include but is not limited to: assistance with transportation, food insecurity, navigation of and application for benefits including, Medicaid, HCBS, working to reduce costs associated with prescription medications, organizing schedules of follow up appointments, alleviating social isolation

• Participate in interdisciplinary review of and coordination around complex patients
• Maintain patient confidentiality in accordance with HIPAA
• Document patient encounters in medical record system in a timely manner
• Follow general policies related to fire safety, infection control and attendance
• Perform all other duties and responsibilities as required

 

Use your skills to make an impact
 

Required Qualifications

• Minimum of 2 years of experience working in health care services and navigating community-based resources

Preferred Qualifications

• Community Health Worker certification (EXCEPTION - State of Texas - REQUIRED)
• Bachelor’s Degree in applicable discipline
• Familiarity with state Medicaid and Medicare guidelines and application processes
• Experience working with seniors’ complex needs
• Prior experience conducting home visits and knowledge of field safety practices

Skills/Abilities/Competencies

• Ability to multi-task in a fast-paced work environment
• Flexibility to fluidly transition and adjust in an evolving role
• Excellent organizational skills
• Advanced oral and written communication skills
• Strong interpersonal and relationship building skills
• Compassion and desire to advocate for patient needs
• Critical thinking and problem-solving capabilities

Working Conditions 

This role has a mobile presence, involving travel to patients’ homes, treatment facilities and community-based settings, and assigned clinics to facilitate connections.

Workstyle: Combination in clinic and field, local travel to meet with members

Location: Must reside in designated market area - Savannah, GA metro area

Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, incremental time may be requested to meet business needs.

Tuberculosis (TB) screening: This role is considered member facing and is part of Humana’s Tuberculosis (TB) screening program.  If selected for this role, you will be required to be screened for TB.

Driver's License, Reliable Transportation, Insurance This role is part of Humana's Driver safety program and therefore requires an individual to have:

• a valid state driver's license,
• carry insurance in accordance with the state minimum required limits, or $25,000/$25,000/10,000 whichever is higher
• and a reliable vehicle.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$53,700 - $72,600 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us
 

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.