Population Health Community Health Coord
JOB
Summary:
Through an equity driven approach, the Population Health Community Health Coordinator collaborates with patients to brainstorm, set, and work towards the achievement of patient-determined goals.
The Population Health Community Health Coordinator improves the effectiveness and efficiency of visits to improve clinical quality and utilization measures, enhance team coordination, produce higher impact care plans, and improve adherence to health recommendations.
The Population Health Community Health Coordinator serves as a liaison to, link to, or intermediary between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
MAJOR DUTIES AND
Responsibilities:
Communication Draws on best practices in motivational interviewing to communicate clearly with clients and all members of the care team within the organization to convey pertinent patient issues, appointment information, provider schedules, and other information Uses basic principles of verbal and nonverbal communication.
Employs techniques for interacting sensitively and effectively with individuals from diverse cultures and communities.
Use methods that promote learning and positive behavior change, such as motivational interviewing Coordinates continuity of patient care with external healthcare organizations and facilities, including hospital admission and discharge and referrals from primary care provider to a specialty care provider Workplace Computers and Equipment Effectively utilizes EMR, reporting software, and other applications to support job function Analytical and Critical Thinking Uses data and evidence-based practices to support individuals and communities in reaching their goals Through collaboration with RN Care Coordinators and Nurse Care Managers, execute individual plans of care using evidence-based algorithms that focus on traditional diabetes and hypertension self-management, screening and management of condition-related complications, and social issues surrounding care Develop and implement outreach re-engagement strategies to patients identified as having significant barriers to accessing and utilizing appropriate care.
Deliver personalized in-home services that support establishing healthy home environments and routines when appropriate.
Checking, Examining, and Recording Compiles summary information to ensure data collection and referral procedures are effective SKILLS AND ABILITIES:
Advocacy and community capacity building skills Effective oral and written communication skills Cultural competency Understanding of ethics and confidentiality issues Knowledge of local resources and system navigation Care coordination support skills Teaching skills to promote healthy behavior change Outreach methods and strategies Understanding of public health concepts and health literacy Comfortable with Microsoft applications (specifically Word, Teams, Excel, PowerPoint) Knowledge about social determinants of health and related disparities Understand the basic principles of public and population health and work with partners in different sectors to achieve positive health outcomes EDUCATION AND/OR
Experience:
Required:
Possess a high school diploma or GED equivalent Preferred:
Successful completion of a Community Health Worker certification training program accredited by the Maryland Department of Health Recommended Skills Algorithms Care Coordination Clinical Works Community Health Confidentiality Critical Thinking Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
Through an equity driven approach, the Population Health Community Health Coordinator collaborates with patients to brainstorm, set, and work towards the achievement of patient-determined goals.
The Population Health Community Health Coordinator improves the effectiveness and efficiency of visits to improve clinical quality and utilization measures, enhance team coordination, produce higher impact care plans, and improve adherence to health recommendations.
The Population Health Community Health Coordinator serves as a liaison to, link to, or intermediary between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
MAJOR DUTIES AND
Responsibilities:
Communication Draws on best practices in motivational interviewing to communicate clearly with clients and all members of the care team within the organization to convey pertinent patient issues, appointment information, provider schedules, and other information Uses basic principles of verbal and nonverbal communication.
Employs techniques for interacting sensitively and effectively with individuals from diverse cultures and communities.
Use methods that promote learning and positive behavior change, such as motivational interviewing Coordinates continuity of patient care with external healthcare organizations and facilities, including hospital admission and discharge and referrals from primary care provider to a specialty care provider Workplace Computers and Equipment Effectively utilizes EMR, reporting software, and other applications to support job function Analytical and Critical Thinking Uses data and evidence-based practices to support individuals and communities in reaching their goals Through collaboration with RN Care Coordinators and Nurse Care Managers, execute individual plans of care using evidence-based algorithms that focus on traditional diabetes and hypertension self-management, screening and management of condition-related complications, and social issues surrounding care Develop and implement outreach re-engagement strategies to patients identified as having significant barriers to accessing and utilizing appropriate care.
Deliver personalized in-home services that support establishing healthy home environments and routines when appropriate.
Checking, Examining, and Recording Compiles summary information to ensure data collection and referral procedures are effective SKILLS AND ABILITIES:
Advocacy and community capacity building skills Effective oral and written communication skills Cultural competency Understanding of ethics and confidentiality issues Knowledge of local resources and system navigation Care coordination support skills Teaching skills to promote healthy behavior change Outreach methods and strategies Understanding of public health concepts and health literacy Comfortable with Microsoft applications (specifically Word, Teams, Excel, PowerPoint) Knowledge about social determinants of health and related disparities Understand the basic principles of public and population health and work with partners in different sectors to achieve positive health outcomes EDUCATION AND/OR
Experience:
Required:
Possess a high school diploma or GED equivalent Preferred:
Successful completion of a Community Health Worker certification training program accredited by the Maryland Department of Health Recommended Skills Algorithms Care Coordination Clinical Works Community Health Confidentiality Critical Thinking Estimated Salary: $20 to $28 per hour based on qualifications.
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