Community Health Worker- Field

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The Aetna Better Health of West Virginia (ABHWV) plan has a successful, 26+ year history of partnering with the State to provide West Virginia’s Medicaid population with top notch health care coordination and service. The plan also has been chosen to provide care coordination to complex foster care children of the state. Through a strong, localized team, an innovative care management model, and creative provider and community advocacy partnerships, ABHWV has successfully assisted the State in achieving high quality standards and outcomes for the Medicaid population across the state. The health plan truly embodies the commitment of West Virginians helping West Virginians. At ABHWV, as a Community Health Worker (CHW) you will join strong teams committed to helping our members and with opportunities for career growth.

Position Summary

The Community Health Worker (CHW) role is a full-time field teleworker position that requires West Virginia residency. Travel with personal vehicle is required 70% of the time or more in the Northern regions of the state, and mileage is reimbursed per company expense reimbursement policy. Field-based travel locations may include but are not limited to member homes, residential treatment facilities, shelters, group homes, and community settings. Qualified candidates must reside in one of the following counties: Lewis, Upshur, Barbour, Harrison, Taylor, Marion, Monongalia, Wetzel, Tyler, Doddridge, Pleasants, Ritchie, Marshall, Ohio, Brooke, and Hancock

The CHW position is part of our care management team, responsible for telephonic and/or face-to-face member contact to assess needs and provide support. This role is heavily community-based with opportunities to serve as a bridge between the member, community, and the healthcare system. CHWs address any gaps in care by connecting members with providers and community resources or services to overcome barriers to their well-being. Through outreach, education, and advocacy, they promote better health outcomes and coordination of care.

CHWs of ABHWV work with all ages in our Medicaid population, which includes youth in our Children’s Specialty program. This program includes foster and child welfare youth and families, along with adopted members, Children with Special Health Care Needs (CSHCN), Children with Serious Emotional Disturbances (CSED) waiver recipients, and youth involved with the Department of Juvenile Justice.

Core standard business hours are 8am to 5pm EST, Monday through Friday, with flexibility to work outside of business hours as needed based on member availability. A flexible work schedule may be available after six months of service and demonstrated performance and attendance.

Position Responsibilities

• •Conduct home visits with Aetna members to assist with needs, including but not limited to locating community resources, scheduling appointments, completing applications for eligible programs, arranging transportation, and educating on services, medications, conditions, etc.
• •Complete telephonic and/or email outreach to members, agencies, care providers, community organizations, etc. regarding member needs and care
• •Collaborate with care team participants, including but not limited to care manager, department workers, legal or custodial guardians if applicable, healthcare providers, community partners, etc.
• •Assess any gaps in care or social determinants of health that may be impeding care or overall well-being and formulate interventions to address any identified areas of need
• •Connect with various community organizations and partners regarding resource availability and eligibility to support member needs
• •Demonstrate flexibility to work in situations where working conditions or environments are unknown, as member homes and situations may vary
• •Document all member outreach and care coordination in electronic health record system in accordance with market processes and maintain the member record to ensure compliance
• •Maintain member confidentiality and protected health information (PHI) according to HIPAA policies and company guidelines
• •Work independently to organize, problem-solve, and prioritize tasks to meet deliverables, deadlines, and expectations
• •Utilize strong interpersonal and communication skills that allow for work with individuals of diverse cultural and socioeconomic backgrounds
• •Travel extensively (70% of the time or more via personal vehicle) to member homes, community locations, various agencies, etc. as indicated
• •Other responsibilities as indicated

Required Qualifications

• •High School Diploma /G.E.D. or higher
• •2+ years relevant experience (i.e. healthcare, community-based, social services, case management, etc.)
• •Complete an approved CHW certification program within 12 months of hire.
• •Demonstrated proficiency with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).
• •Must possess reliable transportation, valid/active driver’s license, and proof of vehicle insurance with ability to travel up to 70% of the time to various locations within the region using personal vehicle. Mileage is reimbursed per company expense reimbursement policy

Preferred Qualifications

• •Experience in community/outpatient setting preferred.
• •Experience in serving the Medicaid Populations in urban or rural environments with knowledge of local formal and informal resource networks preferred.
• •Community Health Worker Certification or equivalent training and experience preferred.
• •Motivational Interviewing skills.
• •Experience with complex children/adolescent populations (to include but not limited to: complex physical health, adoption, juvenile justice and foster care experience), the delivery of behavioral health services, and evidence-based practice preferred.
• •Experience with high-risk, chronic physical and/or behavioral health conditions and interventions (such as experience working in a clinic, provider office, hospital, etc.)

Education

High School Diploma /G.E.D. or higher

License/Credential Requirements

Complete an approved CHW certification program within 12 months of hire.

Work from Home Requirements:

· You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.

· A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.

· Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.

· The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).

· If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements:

· Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.

· Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.

· Collaboration & Schedul