Community Health Worker (CHW) - Public Plans - Worcester MA

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

The Community Health Worker (CHW) assists members in managing their health goals in the community. The CHW role works collaboratively with team members of Point32Health Integrate Care Management team to increase member knowledge, motivation, and adherence to key components of their health care. The Clinical Community Health Worker will arrange, coordinate, evaluate, and advocate for safety net services that provide for basic needs such as education, housing, healthcare, Health harming legal issues transportation and counseling assistance.


• This role is embedded within UMASS Memorial Health Emergency Department, and candidates must have reliable transportation to commute between locations.

• Along with Point32Health employee on-boarding requirements, eligible candidates must adhere to minimum COVID vaccination, annual influenza vaccination policies, and hospital on-boarding trainings as required.

Key Responsibilities/Duties – what you will be doing

• The Community Health Worker will engage in regular telephonic and in-person member assessments pertaining to Social Determinants of Health (SDoH), visits at regularly scheduled intervals, and will conduct urgent visits to ensure that a members' Plan of Care is fully comprehensive and addresses significant medical, behavioral, and social needs.
• Provides culturally appropriate health education, information, and outreach in community settings. This includes homes, schools, clinics, shelters, local business, and community centers
• Bridges the gap between communities and health and human services by increasing members health knowledge and ability to be self-reliant
• Identifies gaps pertaining to Health-Related Social Needs (HRSN) that create barriers to member's care and influence unmet needs
• Responsible for assessing health risks and inputs to the member's care plan and partners with care teams on key care management/care coordination decisions
• Assists members in navigating state and federal benefits and applying when member meets qualifications.
• Assists members in accessing Community Based Organization resources with referrals and warm hand offs.
• Advocates for members to overcome SDoH/HRSN (Health Related Social Needs) barriers such as Housing, Health Harming legal issues , access to health care, and other social need barriers .
• Uses recovery strategies such as motivational interviewing, empathic listening, harm reduction, positive behavioral support techniques, limit setting and strength-based approaches to support members in attaining stated goals.
• Participates in on-going education and training to improve skills and role-specific certifications or specialization.
• Provides consultation and support to other Point 32 Health team members.
• Participates in member and provider health education and outreach campaigns as assigned.
• Provides direct services, such as:
  • 1:1 informal health education counseling.
  • Chronic diseases counseling.
  • Social support.
  • Care coordination and provider navigation.
  • Health services enrollment and health insurance navigation skills.
  • Ensure preventive health screenings.
  • Assists with completion of Advanced Directives.
• Maintains growth and development through self-directed learning activities and involvement in ongoing community health worker education, trainings, and annual competencies.
• Participates in group meetings to ensure policies, procedures, and workflows are up to date and advises on revisions needed.
• Other duties and projects assigned as needed.

Qualifications – what you need to perform the job

COVID Policy

Please note:  We encourage all Point32Health colleagues to follow CDC guidance about COVID-19 vaccines, boosters, isolation, and masking. Point32Health reserves the right to adjust its requirements in response to COVID-19 trends in the communities we serve.

EDUCATION, CERTIFICATION AND LICENSURE:

• Bachelor’s degree in an allied health discipline (e.g., Health Education, Human Services, Public Health, Community Health, Social Work, etc.) preferred
• Credentialed by the Board of Certification of Community Health Workers (CHW certificate) or willing to obtain with assistance of leadership team within one year of employment.

EXPERIENCE (minimum years required):

• 3 - 5 years' experience as a Community Health Worker in a similar position in a health care environment to include 1 year experience with care coordination and/or case/care management, advocacy, community health promotion, resource planning, and community-based visits.

SKILL REQUIREMENTS:

• Excellent written and verbal communication skills.
• Working knowledge of Microsoft Office applications.
• Excellent organizational skills.
• Ability to utilize an Electronic Medical Record.
• Strong understanding of the managed care environment with focus on the Medicare/Medicaid population.
• Strong understanding of federal programs namely, The Affordable Care Act, MassHealth, Social Security and Social Security Disability Insurance.
• Knowledge of welfare reform, homelessness, and community resources to address basic needs such as housing, food, transportation, clothing.
• Knowledge of barriers encountered by low-income and culturally diverse families.
• Demonstrated understanding of community services and navigating the healthcare system.
• Bilingual or multi-lingual.
• Medical terminology knowledge and proficiency a plus.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations
• May be required to work additional hours beyond standard work schedule
• Personal vehicle with current insurance
• Valid driver's license in good standing with a safe driving record
• Ability to travel frequently to member’s homes, hospitals, skilled nursing facilities, PCP office practices and other sites where patients receive care

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent.  We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.