Community Resource Specialist

Description

Petaluma Health Center's mission is to provide high quality health care with access for all in Southern Sonoma County & West Marin. We pride ourselves on our Patient-Centered care while maintaining an engaging environment for our staff. The Center accomplishes this mission through collaborative, innovative programs, services and referral resources that meet the economic needs of the entire community.

FULL TIME EMPLOYEE BENEFITS:

• 21 Days of Paid Time Off
• 10 Observed Holidays
• Medical Insurance (Entire deductible paid by us!)
• 30 Chiropractor and Acupuncture visits per year included with enrollment in our health insurance plans (Kaiser and WHA)
• Dental Insurance
• Vision Insurance
• Gym Membership Discounts at Active Wellness Center and 24-Hour Fitness!
• 401K Matching after 1 year of employment
• Flexible Spending Account, Dependent Care FSA
• Life Insurance (included at no cost to the employee)
• Long Term Disability (included at no cost to the employee)
• Employee Assistance Program (included at no cost to the employee)

Summary: This position is part of a team that is responsible for coordinating quality improvement
efforts and programs within Petaluma Health Center. ECM Health Coach will collaborate with a
multidisciplinary care team in coordinating a wide array of outreach, health care, case management, and member engagement functions in recruiting, supporting and connecting individuals to medical and social services.

Enhanced Care Management (ECM) provide services for members with highly complex needs. ECM is a benefit that provides extra services to help members get the care they need to stay healthy. Our
program coordinates the care a member may receive from different doctors and others involved in the members’ care. At Petaluma Health Center, we understand that certain health conditions like diabetes, hypertension, or substance use disorder can be complex, confusing, and hard to manage. The ECM Health Coach offers supportive services to address the members’ whole health–to care for their body and mind.

Areas of Responsibility

• Facilitate enrollment of members in appropriate medical and supportive services and programs based on the patient s health status, needs, preference, and goals meeting the Petaluma Health Center ECM populations of focus requirements.
• Provide organizational and administrative support for ECM activities to help achieve desired
  program goals including gaining ROI, care plan completion and TAR submission.
• Completes member assessments into ECM Health Risk Assessment and Individualized Care Plan review process towards initiating cases, referral documentation, and referral to other related programs as applicable.
• Coordinate with external entities providing member with some level of care.
• Coordinate with primary care providers, specialists, behavioral health, community based long
  term services and supports needs and oral health providers involved in the care of the member.
• Promote Self-Management education, healthy behavior changes motivation and medication and appointment compliance.
• Scheduling appointments and providing appointment reminders.
• Coordinating transportation and possible accompaniment to critical appointments.
• Identify and help to overcome barriers to adherence to care plan; Promote, coordinate and
  tailor services to meet identified needs.
• Continuously maintains collaborative relationship among all FQHC areas and disciplines to
  facilitate teamwork approach for improving services;
• Participate in all ECM groups meetings, both internally and externally;
• Demonstrate high levels of self-initiation and direction.
• Exercise mature judgement, and are highly motivated, self -starting and proactive. Are excellent at communicating, whether in writing or verbally.

Customer Service:

• Excellent communication skills. Ability to effectively present information, respond to
  questions, and generally communicate clearly and respectfully with patients, coworkers, and
  other external partners as necessary;
• Strong interpersonal skills. Ability to work with people with a variety of backgrounds and
  educational and income levels both in persons and on the phone

Education/Experience:

• High School Diploma, GED, or equivalent required.
• Medical Assistant Certification or Community Health Worker Certificate; Bachelor’s degree
  in Healthcare Administration, Nursing, Behavioral Health, Social Science or a related field
  preferred.
• At least two (2) years of professional level outpatient medical, community health service
  delivery, behavioral practice management, or related healthcare experience, including some
  lead or supervisory responsibility preferred.
• At least two (2) years of experience working in a community-based setting, preferably in a
  non-profit setting required.

Licenses and Certifications:

• Medical Assistant Certification or Community Health Worker Certificate preferred.
• Current Basic Life Support (BLS) certificate required.

Language Skills: Bilingual in English and Spanish, written and verbal fluency required

Petaluma health Center is an Equal Opportunity Employer. Petaluma health Center does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.