Field Community Health Worker (Wayne or Macomb County)

Become a part of our caring community   The Community Health Worker (CHW) 1 serves as a liaison between health and social services and the community, identifying health-related issues, collecting data, and discussing concerns with the people served. The Community Health Worker 1 works assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The Community Health Worker (CHW) 1 serves as a key member of our care teams, applying a hands-on approach to member engagement. The CHW 1 supports case management functions, addresses social determinants of health (SDOH) needs, improves self-management of chronic conditions, navigates the healthcare system, and promotes prevention and health education tailored to the needs of the communities we serve. Leveraging their knowledge of the community and shared life experiences, the CHW 1 informs their interactions with members and community partners. This position will be based from a home office and will travel 25-50% of the time, to an assigned area in Wayne and/or Macomb county, to conduct in home visits with Medicare/Medicaid members. Must reside in Michigan with the ability to drive to Wayne or Macomb Counties.

Responsibilities: Serve as an integral member of care teams, applying a hands-on approach to member engagement. Support case management functions and address social determinants of health (SDOH) needs. Assist members in improving self-management of chronic conditions. Navigate the healthcare system and promote prevention and health education tailored to community needs. Leverage knowledge of the community and shared life experiences to inform interactions with members and community partners. Conduct in-person assessments to understand member care needs, preferences, socioeconomic barriers, and evaluate the home environment. Assist members in navigating healthcare and social service systems, coordinate access to basic needs (e.g., housing, food, income, transportation), and schedule physical and behavioral health visits. Advocate for members with providers, community resources, schools, and others, including accompanying members to provider visits as requested. Identify and address barriers to healthy living and healthcare access, ensuring members can attend their appointments. Support highest-risk, hardest-to-reach member cohorts, with a particular focus on members who may have a history of mistrust with the healthcare system. Promote and monitor adherence to care plans, providing motivational interviewing to support medication and treatment adherence. Provide social support to boost members’ morale and sense of self-worth, serving as a trustworthy, reliable, non-judgmental, consistent, and accepting team member. Support member self-management through culturally appropriate health education and coaching. Conduct research and in-person outreach to locate difficult-to-contact members to increase assessment completion and participation in clinical programs. Build and maintain relationships with providers and community resources to support member referrals and implement community assessments to identify resource gaps. Regularly travel to conduct member visits, provider visits, and community-based visits as needed to ensure effective program administration. Work collaboratively with other associates as a member of the care support teams, including care coordinators, housing specialists, and SDOH