Spanish Community Health Worker II
 Massachusetts General Hospital | |
 United States, Massachusetts, Chelsea | |
| 151 Everett Avenue (Show on map) | |
 Feb 13, 2025 | |
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GENERAL SUMMARY/ OVERVIEW STATEMENT:
MGH strives to advance health equity, improve health outcomes, and promote well-being of our primary care patients by addressing health-related social needs, system navigation, and care coordination as standard of care. Community Health Workers (CHWs) are an integral part of achieving these goals. CHWs build trust with their patients and help them to improve access and coordinate their health care. CHWs have the skills and experience to understand their patients' circumstances. By walking alongside their patients, CHWs help to address medical and psychosocial needs in order to promote self-efficacy, help patients meet their goals, and improve health outcomes. CHWs use their unique skills (motivational interviewing, trauma sensitive care, coaching, etc.) to help patients manage their chronic diseases, adhere to medications, connect to community resources and gain strength and confidence in managing their own health. In addition, the community health worker will work with patients to help decrease barriers to timely follow-up care in the midst of challenging social, environmental and economic situations. The CHW will aid patients in the coordination and completion of appointments inside and outside of MGH. CHWs will work with patients to alleviate social determinants of health as well as improving their overall health and well-being. While the community health worker is not a clinical position, it requires a good knowledge (ability to learn) of basic clinical concepts and an understanding of when a referral to a licensed clinician is appropriate. PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Engagement and Assessment *Provide community health work services for patients identified as at-risk due to medical or psychosocial challenges. *Complete an assessment with the patient and provider to identify the specific areas of focus for the CHW work with particular at-risk patients. *Engage with patient, build trust and identify patient's barriers. Work with patients and providers to set goals for patient's care. *Educate, motivate and guide patients to meet their health goals. *Provide culturally sensitive services to patients from different cultures. *Help the patient to put systems in place in their own environment to assist with the management of their care. System Navigation, Health Coaching, Care Coordination and Social Determinants of Health (SDOH) *Help to address any logistic barriers, scheduling complications, childcare needs, etc., that would prevent a patient from showing up at their appointment. *Assist patients in organizing their records, making follow up appointments and filling their prescriptions. *Help patients to develop their own plans for getting to various appointments for screening and diagnostic tests, and treatment services. *Make regular home visits as needed and or meet patients in the community or in a safe outdoor space to conduct visits when and where appropriate to follow up on key aspects of the patient's care and to assess the in-home barriers to compliance. *Accompany patients to specialty and imaging centers when needed to provide support and advocacy. *Connect patients to community resources related to SDOH needs, including food, housing, transportation, and other areas as needed. *Work with primary care providers to reinforce health education messages - the importance of follow-up care, medication adherence, routines of self-care, etc. *Review and educate patients on the preparation for colonoscopy, pap smear, mammogram, and other visits to specialty or imaging departments. *Refer to internal or external case management services when other issues are identified (i.e. hunger issues, domestic violence issues, etc.) *Provide advocacy, patient education and support in accessing community-based and hospital-based programs. *Develop and maintain a strong working relationship with the schedulers of screening appointments *Work with medical interpreters to reach patients of other languages. Collaboration and Documentation *Maintain regular communication with the patient's providers through clinical messages in the electronic health record, emails, phone calls and case review meetings. *Document each patient encounter in detail. Track benchmarks of progress in care - including short term goal completion along the way. *Enter notes of intervention into the appropriate electronic health record *Produce mid-year and end of the year reports on program activities compiling data from data bases and writing up case examples. Educationneeds, system navigation, and care coordination as standard of care. Community Health Workers (CHWs) are an integral part of achieving these goals. Physical Requirements The General Hospital Corporation is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. | |