Community Health Worker (CHW)

Description

About Jordan Valley Health:

Jordan Valley Health (JVH) is a mission-driven organization dedicated to improving the health of individuals and families in underserved communities. We provide comprehensive healthcare services including primary medical, dental, vision, and behavioral health. Our mission is simple: Improve our community’s health through access and relationships. By working collaboratively with partners and continually innovating, JVH strives to be a leader in providing essential healthcare for the underserved, ensuring everyone in our community has access to quality healthcare.

Job Summary:

The Community Health Worker (CHW) plays a critical role in advancing the mission of the Federally Qualified Health Center by improving access to care, addressing social determinants of health, reducing barriers, and supporting patients navigating healthcare and social services. This position serves as a trusted liaison between patients, the health center, and community resources. The CHW is responsible for determining and issuing Sliding Fee Scale (SFS) discounts, assisting patients with Medicaid applications, and determining and issuing Presumptive Eligibility (PE) for Medicaid in compliance with Health Resources and Services Administration (HRSA), state Medicaid, and organizational requirements. The CHW is responsible for connecting patients to community resources.

Key Responsibilities:

Patient Access & Navigation

• Provide patient-centered, culturally competent education and support to individuals and families.
• Assist patients in navigating healthcare services, insurance coverage, and community resources.
• Identify and address social determinants of health that may impact access to care, i.e. PRAPARE.
• Advocate for patients to ensure timely access to medical, dental, behavioral health, and enabling services.
• Follow up on appointments or instructions from the healthcare team by making home visits, meeting the participant in a community setting, and/or phone communication.
• Build relationships and interact professionally with local community partnerships, health, and social service providers.

Sliding Fee Scale (SFS) Administration

• Screen patients for Sliding Fee Scale eligibility in accordance with HRSA and organizational policies.
• Accurately determine and issue Sliding Fee Scale discounts based on income and household size.
• Educate patients on the Sliding Fee Scale program, eligibility requirements, and renewal processes.
• Ensure all documentation supporting SFS determinations is complete, accurate, and audit ready.

Medicaid & Presumptive Eligibility

• Assist patients with Medicaid applications, renewals, and changes, including gathering required documentation.
• Determine and issue Presumptive Eligibility for Medicaid in compliance with state and federal guidelines.
• Clearly explain eligibility determinations, coverage timelines, and next steps to patients.
• Track and follow up on applications to ensure continuity of care and coverage.

Teamwork & Organizational Goals

• Promote effective working relations and work as part of a team to facilitate the organization’s ability to meet its goals and objectives.
• Attain all agreed-upon goals and objectives within specified time frames, contributing to the organization’s overall mission.
• Consistently meet monthly individual productivity goals and key performance indicators (KPIs) as determined by Management.

Compliance & Documentation

• Maintain accurate, timely documentation in the electronic health record (EHR) and eligibility systems.
• Ensure compliance with HRSA, Medicaid, and FQHC regulatory requirements.
• Protect patient confidentiality and comply with HIPAA and organizational privacy policies.
• Participate in internal audits, quality assurance activities, and compliance reviews as required.
• Stay current on changes to Medicaid, Presumptive Eligibility, and Sliding Fee Scale regulations.
• Responsibly follow the Clinic Exposure Control Plans, including protocols for Bloodborne and Airborne Pathogens.
• Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to maintain a professional, responsible, and courteous environment.
• Provide metrics if needed to meet various GRANT funded initiatives

Collaboration & Outreach

• Collaborate with registration, billing, care teams, case management, and leadership to support patient access.
• Refer patients to internal programs and external community resources, including housing, food assistance, transportation, and social services.
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