Inland Empire Health Plan Community Health Worker

Position Summary/Position

Under the direct supervision of the Enhanced Care Management Department Leadership, the Community Health Worker – ECM (CHW-ECM) will be responsible for supporting Members in improving their whole health, through outreach and engagement activities, which are primarily field based. The CHW – ECM works closely and collaboratively with the Enhanced Care Management team (ECM), as well as with the designated HCO medical teams, to ensure high quality and seamless care for Members.

Major Functions (Duties and Responsibilities)

1. Responsible for assisting Members in navigating the healthcare system by finding and following up by phone and in person with hard-to-reach Members, helping Members successfully participate in their medical and/or behavioral health care by overcoming barriers to care, and sharing information on barriers with IEHP and Providers to improve the Enhanced Care Management team.
2. Model the highest ethical behavior in relationships with co-workers, supervisors, Members, Providers, and colleagues in the community.
3. Responsible for engaging with Members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, as well as to increase the Member’s sense of control over their whole health.
4. Delivering information about health and wellness in ways that the community can easily understand and providing information on IEHP Member benefits and services.
5. Providing advocacy on behalf of IEHP Members in the home, the community, and in provider organizations.
6. Responsible for building and maintaining a positive working relationship with Providers, including, but not limited to, communication via in-person, over the phone, and through digital means such as email and fax.
7. Responsible for assisting the Enhanced Care Management team and Providers to understand the culture, norms, beliefs and preferences of the Members and their community by representing the voice of the community, helping to create messages and materials that fit community culture, and delivering these messages in a way that fits the culture of Members.
8. Responsible for promoting a collaborative and effective working environment within the Enhanced Care Management team by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions.
9. Collaborates on Member care issues with other Enhanced Care Management Team Members and consults with Nurse Care Manager and/or the Behavioral Health Care Manager before taking any action that is clinical in nature.
10. Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.
11. Ensures documentations is accurate, useful and in compliance with regulatory requirements and accreditation standards.
12. Participates in all appropriate staff meetings or other activities as needed.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leading: Self

Experience Qualifications

Two (2) years of experience as a Community Health Worker, Promotora, or Health Navigator, or two (2) years of experience working in community outreach, customer service, or within a medical office, or a Behavioral Health or Substance Use Disorder program required.

Preferred Experience

Education Qualifications

High school diploma or GED required.

Preferred Education

Professional Certification

Has successfully completed an approved Community Health Worker program or will complete within six (6) months of hire.

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver’s license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.

Knowledge Requirement

Knowledge of the community the CHW will be working in, especially non-professional resources, and their reputation in the community. Understanding of and sensitivity to mental health conditions and addictive disorders. Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both. Understanding of, and a commitment to, high preforming team practices.

Skills Requirement

Bilingual (English/Spanish) preferred.

Highly skilled interpersonally, with excellent teamwork and relationship skills.  Highly skilled in interpersonal communication, including resolving conflict. A high degree of skillful decision making and judgement, in an autonomous position, including knowing when to consult with the team, supervisors, and experts.

Abilities Requirement

Able to sufficiently engage members in a variety of settings, including on the phone, at Member’s homes, in hospitals and other settings. Ability to develop relationships with community members and leaders, including in the faith-based community. Able to develop effective relationships with team members, despite working primarily in the field.

Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

Minimal physical activity; may include standing and repetitive motion.

Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.

Work Model Location

Telecommute

Physical Requirements

Keyboarding: Traditional – FREQUENTLY

Keyboarding: Touch-Screen – FREQUENTLY

Keyboarding: 10-Key – FREQUENTLY

Hearing: One-on-One – FREQUENTLY

Near Visual Acuity – FREQUENTLY

Communicate: Information/ideas verbally – FREQUENTLY

Sitting – CONSTANTLY

Lighting – CONSTANTLY

Indoors – FREQUENTLY

Regular contacts: co-workers, supervisor – FREQUENTLY

Memory – FREQUENTLY

Understand and follow direction – FREQUENTLY

Regular and reliable attendance – CONSTANTLY

A reasonable salary expectation is between $48,110.40  and  $59,425.60, based upon experience and internal equity.