Position Description – Community Health Worker
**This position is assigned to Behavioral Health Telephone Support, assisting patients by phone with scheduling, follow-up, and coordination of behavioral health services.**
JOB SUMMARY: The Community Health Worker (CHW) helps patients access and navigate HOPE Family Health services and community resources. The CHW communicates with patients and care teams, identifies barriers to care, coordinates follow-up, and documents services accurately. Depending on the assignment, the CHW may focus on medical or behavioral health telephone support, language access, referrals, outreach, care coordination, or connecting patients with resources such as food, housing, financial assistance, and transportation. Each CHW performs duties within their assigned area, training, credentials, and HOPE policies. Individual CHWs are not expected to perform every duty listed in this position description.
PRIMARY DUTIES & RESPONSIBILITIES:
- Build respectful, trusting relationships with patients and families; communicate in a culturally responsive manner and support patient choice and self-advocacy.
- Contact patients by telephone, electronic message, or in person as assigned; respond to questions, relay approved information, identify needs, and route clinical concerns promptly to the appropriate licensed staff or provider.
- Help patients understand appointments, care plans, referrals, tests, and next steps using information approved by the care team; reinforce education and instructions without independently diagnosing, treating, or giving clinical advice.
- Identify barriers to care, including transportation, insurance, cost, language, food, housing, and access to services; connect patients with HOPE programs and community resources and follow up on connections as assigned.
- Coordinate with medical, behavioral health, pharmacy, and other teams and external partners to support continuity of care and timely follow-up.
- Maintain timely, accurate records of contacts, referrals, services, and follow-up in the electronic health record and other approved systems; protect confidential information.
- Participate in team meetings, training, quality improvement activities, and updates to resource information and workflows.
DUTIES BASED ON ASSIGNMENT AND QUALIFICATIONS:
- Telephone support: manage incoming and outgoing patient communications, route messages, relay provider-directed results or instructions, and support medical or behavioral health workflows. Clinical triage or assessment is performed only by staff whose credentials, role, training, and HOPE authorization permit it.
- Referral coordination: track referrals, gather and transmit information through approved channels, obtain required authorizations, coordinate specialty appointments, inform patients of status and next steps, and follow up on completion.
- Language access: provide bilingual navigation and, when separately qualified and authorized under HOPE policy, interpret spoken communication or translate written material. Arrange qualified language assistance when needed.
- Records and care coordination: process assigned records and correspondence, obtain or document appropriate releases, support discharge follow-up and external service coordination, and respond to authorized information requests.
- Community engagement: participate in outreach, health fairs, patient education, resource navigation, and other community-based activities when assigned.
INTERMITTENT DUTIES:
- Performs other duties as assigned by Team Leader to support departmental operations and organizational needs.
OFF-SITE WORK:
- Off-site work is not a requirement of this position.
- With prior Team Leader approval, various job tasks may be completed remotely. These may include, but are not limited to: trainings, conferences, meetings, and daily activities that need to be completed by a deadline.
- At times working off-site for this position can be completed at the home of the employee. Employees approved for off-site work must have a confidential, designated workspace to ensure privacy and productivity.
- Off-site work classification and arrangements will be reviewed by the Team Leader at hire, during annual performance evaluations, and as needed throughout the year.
SKILLS/QUALIFICATIONS:
- High school diploma or equivalent required; relevant experience in health care, behavioral health, patient service, community outreach, or resource navigation preferred.
- Ability to communicate clearly and respectfully with patients, colleagues, and community partners; organize competing tasks and use sound judgment about when to escalate concerns.
- Ability to use electronic health records and standard office software, or to learn them with training; knowledge of local resources and barriers to care preferred.
- Additional language proficiency, interpreter qualifications, professional credentials, and Basic Life Support certification may be required for specific assignments. Any clinical duties require applicable credentials and HOPE authorization.
PERSONAL ATTRIBUTES:
The ideal candidate will consistently demonstrate the following qualities:
- Trustworthiness and integrity
- Respect for patients, colleagues, and community members
- Cultural humility and sensitivity to diverse backgrounds
- Flexibility and adaptability in a dynamic healthcare environment
- Strong work ethic and commitment to excellence
- Compassionate and patient-centered approach to care
WORKING CONDITIONS & PHYSICAL DEMANDS:
- This role functions primarily in a professional office or clinical environment with occasional travel between HOPE sites.
- Occasional extended hours may be required based on organizational needs.
- Potential exposure to health hazards, including body fluids, within the healthcare setting.
- Must be able to communicate effectively in English, both verbally and in writing; fluency in a second language is helpful but not required.
- Requires sufficient vision and hearing to perform duties and communicate by phone and in person.
- Occasionally required to lift or move items up to 25 pounds..
Note: This job description is intended to convey information essential to understanding the scope of the Community Health Worker position. It is not intended to be an exhaustive list of qualifications, duties, or responsibilities, as other duties may be assigned as needed.
This job description follows the Americans with Disabilities Act (ADA) and the Fair Labor Standards Act (FLSA) (May 1995)
HOPE Family Health Services is an equal opportunity employer who complies with applicable State and Federal civil rights laws and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran or disability status.
Many positions at HOPE Family Health Services are funded in-part or in-whole by State or Federal Department of Health and Human Services funding and as such, our organization cannot employ individuals with certain criminal backgrounds or who are on State or Federal exclusion or debarment lists.
— Sarah J.
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Marketing Manager
★★★★★
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