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Community Health Worker II / 40 Hours / MGH-Main Campus & Health Centers

Company: Partners Healthcare System
Location: chelsea
Posted on: May 3, 2021

Job Description:

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 are trusted members of the community who help patients improve access and coordinate their health care. CHWs have the skills and experience to understand their patients' circumstances. By building trusting relationships and walking alongside their patients, CHWs help address medical and psychosocial needs in order to promote self-efficacy, help patients meet their goals, and improve health outcomes.

Research indicates housing, food, financial and other forms of socioeconomic insecurity impact health outcomes. To improve our patients' health and wellbeing, MGH primary care patients are screened for both medical and social determinants of health (SDH) needs. CHWs work with a panel of patients who have screened positive for SDH needs and/or are identified for chronic disease health coaching.


Patient Engagement and Assessment

* Engage patients identified for CHW services via telephone, home visit (or "porch" visit during COVID), and accompaniment to medical appointments and community services. * Utilize motivational interviewing to help patients identify their own health goals, support adherence to care plans, and identify and address barriers to medical care. * Collaborate with interdisciplinary primary care team to identify care plan goals. * Provide culturally sensitive services to patients from diverse racial, cultural, and socioeconomic backgrounds; utilize medical interpretation as needed.

Systems Navigation, Health Coaching, and Care Coordination

* Provide targeted interventions to a panel of identified patients to help adopt healthy behaviors designed to alleviate hypertension and address the social determinants of health (SDOH) that play a critical role in health outcomes. * Assist patients to navigate healthcare system, including helping patients schedule, obtain transportation, and attend appointments; accompany patients to appointments as needed. * Research and connect patients to community resources related to SDOH needs, including food, housing, transportation, legal services, and other identified needs.

Collaboration and Documentation

* Document care within the electronic medical record. * Collaborate and communicate with care team via email, telephone, and case conferences. * Produce regular reports on program activities compiling data and written case examples.


* High school diploma or GED required * Relevant prior work experience, OR associate or bachelor's degree preferred * Minimum two years of work experience * Previous work in community settings preferred


* Strong interpersonal skills * Assessment and problem-solving skills * Ability to work independently and within a multi-cultural team * Demonstrated organizational and time management skills * Demonstrated ability to work effectively and provide advocacy for racially and ethnically diverse populations and communities preferred * Strong commitment to social justice and health equity * Experience working as a patient navigator/community health worker preferred * Strong oral and written communication skills * Proficient in all Microsoft Office Suite, including Outlook and Excel * Demonstrated ability to work effectively and provide advocacy for racially and ethnically diverse populations and communities preferred * WORKING CONDITIONS: Describe the conditions in which the work is performed. * Position is community-based, with regular travel between medical offices, patients' homes (or "porches" during COVID), and community organizations as needed for patient care.

Keywords: Partners Healthcare System, Chelsea , Community Health Worker II / 40 Hours / MGH-Main Campus & Health Centers, Other , chelsea, Massachusetts

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