Community Health Worker, Care Management - Evolent Health : Job Details

Your Future Evolves HereEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.Join Evolent for the mission. Stay for the culture.What You'll Be Doing:Our goal is partnering with the nation's leading health systems in their strategic evolution to positively impact and improve the healthcare delivery system. Collaboration Opportunities Our Care Management team offers candidates the opportunity to make a meaningful impact by providing exceptional support for our patients, fostering a sense of job satisfaction through team-approached problem-solving and positive interactions. Our team values collaboration, continuous learning, and a patient-centric approach, ensuring that every team member contributes to providing better health outcomes for this population.The Community Health Worker works collaboratively with a team of RN Care Advisors, Social Workers, Pharmacists, Care Coordinators, and Health Educators daily to help coordinate the care of our patients to ensure a holistic approach to helping our patients meet their health goals. What You'll Be Doing:The Community Health Worker will work as an extension of the clinical care team. The person taking this role will be assigned patients and will manage their caseload through in-person, telephonic, and electronic communications, and coordination. The Community Health Worker must reside or live within 50 miles of Allegany County in Maryland.

• Conduct home visits with patients to assist with SDoH barriers or other needs identified by the CM team.
• Engage with patients in person who need assistance with self-care needs beyond what a nurse care advisor can provide via phone.
• Accompany patients to their visits.
• Document activities in the Identifi system, including care plan activities conducted.
• Conduct initial outreach calls to encourage patients and care givers to participate in care management programs.
• Help patient access community and governmental based service agencies including possibly filling out paperwork with/for the patient.
• Arrange transportation.
• Coach and guide the patient to meet both personal and clinical goals.
• Schedule provider visits on behalf of their patients.
• Remind patients of their upcoming visits.
• Address language and cultural barriers to care and self-care.
• Facilitate closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
• Participate in the integrated care team meetings.
• Participate in community health fairs and events.

Qualification - Required and Preferred

• Valid Driver's License (Required )
• Washington, Allegany, Garrett Counties (Required )
• Healthcare background (Preferred)
• Ability to unite with people and comprehend the challenges they face (Preferred)
• Experience assisting patients with Social Determinants of Health (SDoH) needs (Preferred)
• Demonstrated success in working as part of a multi-disciplinary team including speaking and working with Physicians and Registered Nurses(Preferred)
• Medical Assistant, Nursing Assistant, Engagement Specialist or Community Health Worker Certification (Preferred)
• Experience working with patients with chronic and behavioral health needs (Preferred)
• Bilingual (Preferred)

Technical Requirements: We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact [email protected] for further assistance.The expected base salary/wage range for this position is $21-$24/Hour. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.