Health Plan of San Mateo
Pediatric Community Health Worker
Health Plan of San Mateo, South San Francisco, CA, United States
The Pediatric Community Health Worker (CHW) will provide care coordination, health education and navigation, and care management services that are medically necessary for HPSM's infant and toddler members, as well as members in their families. These include connecting members to primary care, addressing social determinants of health (SDOH), and providing or coordinating access to other needed services to improve members' physical and mental health. The CHW will act as a liaison collaborating directly with primary care offices, social services, and the community to facilitate access to services and improve the quality, health equity, and cultural competence of service delivery. The CHW will play a critical role in improving the health and well-being of members by using their knowledge of members' communities and common lived experiences.
Position overview
- Maintain a caseload of members with complex needs
- Function as a liaison between members and providers, coordinating services among multiple providers and community agencies on behalf of members' and their families.
- Provide Health Education and outreach to members, promoting wellness and prevention. This may include providing information, instruction, coaching and goal setting to improve a member's physical and mental health, address barriers and/or ability to self-manage health conditions.
- Function as a health navigator providing members with information, training, referrals, advocacy on their behalf, or other assistance to help members receive services related to perinatal care, sexual and reproductive health, environmental and climate-sensitive health issues, oral health, aging, injury, domestic violence and other violence prevention services.
- In conjunction with Manager, develop and support the implementation of member-centered, individualized Care Plans. This includes responsibility for:
- Administering Assessment of Health and other appropriate assessment tools to members as needed.
- Assisting members in identifying their goals (health, behavioral, social, etc.) and support them in achieving those goals.
- Independently conducting telephone or in-person assessments for members referred for care coordination or care management, assessing needs related to physical or behavioral health Activities of Daily Living (ADLs) / Instrumental Activities of Daily Living (IADLs), Long-Term Services and Supports (LTSS), SDOH and other needs for community resources or services.
- Partnering with members to help identify their own strengths and barriers to help them be successful with meeting their care plan goals with respect members' health choices staying member-centric in the care planning process.
- Preparing care plans for members for presentation at interdisciplinary team meetings, as needed.
- Ensuring treating providers, family and / or community support personnel are aware of member care plans as appropriate
- Support in the provision of basic population health management and preventative care services managing a caseload of members.
- Function as part of a multidisciplinary care team to manage plan members utilizing a population health management approach through active participation and member advocacy.
- Maintains required and complete documentation for all activities in the plan's care management system, MHK.
- Facilitate interdisciplinary communication and hand offs to other team members.
- Provide members and those in the members' care teams information about HPSM benefits, programs, and processes, staying up to date on this information as there are changes.
- Provide subject matter expertise to other team members and partners on community resources and programs.
- Participate in continuous quality improvement efforts.
These are the qualifications typically needed to succeed in this position. However, you don't need to meet every requirement to apply.
License and Certification:
- Must possess a Community Health Worker (CHW) Certificate.
- Two thousand (2,000) or more hours working as Community Health Worker (CHW) in a paid or volunteer position in the last 4 years.
- High school diploma required. Associate degree or bachelor's degree preferred.
- Experience working with youth and families.
- Lived experience relevant to HPSM's member population is strongly preferred.
- Knowledge of and experience navigating medical, social, and/or behavioral health systems preferred.
- One (1) or more year of experience in a community/outpatient setting preferred.
- Care coordination experience in a managed care setting and / or with Medicaid populations.
- Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint.
- Techniques and best practices for member needs assessments, care planning, and care management.
- Medi-Cal and Medicare benefits
- Comprehensive knowledge of care transitions processes, and the needs of members when transitioning between care settings.
- Personal Health Information (PHI) privacy and security requirements and best practices for maintaining confidentiality of health information.
- Adapt to changes in requirements/priorities for daily and specialized tasks.
- Work autonomously and be directly accountable for member care management.
- Work collaboratively with others.
- Work in partnership with a team and support team decisions.
- Utilize member-centric approach to care coordination and care transition.
- Function effectively in a fluid, dynamic, and rapidly changing environment.
- Work effectively with people in varying positions and diverse backgrounds, by maintaining cultural competency knowledge and practice.
- Influence and gain consensus on individual and group decision-making.
- Maintain working knowledge of confidentiality practices and standards. Adhere to all standards
- of confidentiality and patient health information.
- Quickly build subject matter expertise, including developing a comprehensive knowledge of Health Plan of San Mateo programs, community partners and resources.
- Demonstrate excellent verbal and written communication skills with various audiences and individuals of diverse backgrounds.
- Communicate effectively through written, verbal and listening communication skills.
- Demonstrate member, provider and interdisciplinary team focused interpersonal skills.
- Conflict resolution, assertiveness, and collaboration skills.
- Bilingual skills highly preferred, particularly Spanish.
The starting salary range is $33.32-$42.80 per hour, depending on the candidate's work experience.
Excellent benefits package includes:
- HPSM-paid premiums for employee's medical, dental and vision coverage (employee pays 10% of each dependent's premiums)
- Fully paid life, AD&D and LTD insurance
- Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
- 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
- Tuition reimbursement plan
- Employee wellness program
Other details
- Pay Type Hourly
- Min Hiring Rate $33.32
- Max Hiring Rate $42.80
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