Community Health Worker, Hospital Care Transition Program

RIPIN
South County Hospital, Wakefield
$20-22/hr
Personal Experience Navigating Systems

Job Summary:

The Community Health Worker (CHW) is a peer who has experience in navigating Rhode Island’s health system for themselves, a family member or through previous employment. This CHW will work in RIPIN’s Hospital Care Transition Program, which supports Rhode Islanders who may be good candidates to discharge from the hospital back to their homes or other community settings, but need a little extra assistance to make that possible. The CHW will be a critical part of a comprehensive team providing options counseling, resources and referrals for post-hospital care. CHWs will engage with consumers in hospital settings providing person centered, culturally sensitive support, and building on the values, strengths and preferences of the patient. The CHW will also serve as an effective role model and mentor.

Essential Functions:

  • Assist patients and families in understanding and accessing informal and formal options for post-discharge care benefits including copay and cost of care.
  • Review and educate on benefits and eligibility for Medicaid Fee-For-Service, Medicaid/Medicare Managed Care, Medicare Advantage Plans, and any available private insurances.
  • Assist the consumer in completion and submission of enrollment or benefit applications. Refer consumers to other services and public or private agencies for additional supports as needed.
  • Utilizing motivational interviewing skills and culturally sensitive methods to collaborate with patients to explore preferred post-discharge supports and identify social determinants of health and/or areas of need within their community environment. Review care options including natural supports, home care services, medical equipment, adult day health programs, senior centers and assisted living communities.
  • Coordinate with hospital discharge and health plan staff to enable post-discharge home and community supports to be established in a timely manner.
  • Assist consumers as they transition to independence/case closure by engaging with consumers and providing follow up support.
  • Maintain timely, accurate records, documentation, and reports as required.
  • Actively participate and complete training and professional development activities.
  • Assist in statewide system analysis, planning and coordination with state agencies, state and local boards, community-based organizations, and community rehabilitation programs.
  • Accept other duties and responsibilities as assigned.

Qualifications

Knowledge, Skills and Abilities:

  • Ability to demonstrate sensitivity towards, relate to, form trusting connections with, and motivate consumers as a peer mentor and to address barriers to care, health and wellness
  • Knowledge of Rhode Island health systems, terminology, supports, and services
  • Demonstrated ability and skill to work collaboratively with co-workers, consumers, families, service providers, and health plans, etc.
  • Skilled and/or willingness to learn and initiate motivational interviewing techniques with consumers
  • Demonstrated prior success in accessing community-based resources in Rhode Island
  • Strong written and oral communication skills
  • Excellent organizational skills to manage multiple priorities and tasks
  • A deep understanding of, commitment to, and ability to carry out the mission, vision, philosophy and values of RIPIN
  • Demonstrated proficiency with Microsoft Office/computer skills to enter data, prepare reports and correspondence

Education and Experience:

  • High School diploma or GED
  • Attained or working towards a bachelor’s degree, or a combination of education, experience, and skills to effectively carry out responsibilities and assignments
  • Community Health Workers certification preferred; non-certified incumbents are expected to earn certification within 18 months of hire date
  • Personal experience navigating state and community services and programs on behalf of self or a family member
  • Previous experience supporting families or individuals with special care needs or disabilities or families or individuals accessing health programs and services
  • Demonstrated ability to work both independently and as an effective team member
  • Demonstrated experience working with diverse populations
  • A combination of education and experience demonstrating acquisition of the skills and abilities required