Community Health Worker HPP
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Job ID: 142705
Category: Customer Service/Patient Access
Work Type: FT
Location: Philadelphia, PA, United States
Work Schedule: Full time, Day Shift,
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Summary:
- Community Health Workers HPP (CHW) are employed by practice sites via funding from the DHS Amendment/Community Based Care Management Program and work solely with practice site members who fall into the Top 5% of HPP members who are categorized as part of this program. The program as such is scheduled to run for a period of no longer than 24 months.
This position is part of the Family Practice team.
Responsibilities:
General Responsibilities
- The CHW, through practice based and home visits, enhances communication between the care team and the patient to assure adherence to the care plan.
- The CHW promotes positive behavior change; assists with addressing health issues; and identifies non-medical needs of patients.
- The CHW collaborates with the health care team in the development and monitoring of the plan of care for patients assigned.
- The CHW inputs relevant, usable data into practice sites EHRs for collection by HPP and reporting to DHS.
- The CHW utilizes database, to identify and access social service needs for members in the Community Based Care Management Program.
- The CHW attends on the job training sessions and other training sessions to develop personal resources and keep abreast of current trends in healthcare.
Job Responsibilities
- Assists in the assessment of high risk patients and identifies potential health risks and gaps in Non-medical needs such as utilities assistance, food, medications, transportation and other potential needs that can be coordinated using community based resources.
- Works with the health care team on patients considered to be high risk due to their clinical condition or non-medical needs that may interfere in the management of the HPP of care.
- Inputs relevant, usable data into practice site EHRs for collection by HPP and reporting to DHS on program deliverables.
- Coordinates behavioral health services with Community Behavioral Health's Community Based Care Management team.
- Supports the plan of care through in-office interviews and discussions as well as using home based visits to foster communication and identification of other health risks such as child and/or adult abuse.
- Attends appointment(s) with the patients to assist in the interpretation of outcomes and needed follow-up activities.
- Regularly documents all CHW activities in the patient record.
- Participates in data collection and reporting activities.
- Communicates regularly with care team.
- Participates and supports relevant care planning efforts.
- Works with a social needs referral service to meet help meet member needs.
- Training on and implementing data reporting systems.
Credentials:
Education or Equivalent Experience:
- H.S. Diploma/GED (Required)
- 0-1 years relevant experience
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
