Community Health Worker

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

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 central, south, and west 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: Kanawha, Putnam, Jackson, Lincoln, Roane, Clay, Nicholas, Fayette, Boone, or Raleigh.

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 extensive