Reports to the Medical Respite Program Coordinator or designee.

The Medical Respite Community Health Worker (CHW) focuses on addressing patients� Social Determinants of Health and provides them with individualized support around their longitudinal healthcare and social needs. The Medical Respite CHW will assess and coordinate care for patients throughout their admission to the Medical Respite Program. They will coordinate a warm handoff to community or internal providers at time of discharge for follow up needs.

Works collaboratively with patients and various members of interdisciplinary teams both in the hospital and community. Patient population may include those with but not be limited to the following concerns: medical complexities homelessness substance use mental health uninsured or underinsured and other psychosocial needs.

Completes initial assessments with patients and providers to identify specific areas of focus patient strengths and barriers to care.

Provides patients with education about their care plans and personal needs working to build self-efficacy.

Works collaboratively with external stakeholders (such as community partners and payors) as needed to ensure that patients are provided with the appropriate support needed to engage with resources and improve their overall health and well-being.

Escalates any patient or program concerns to the Program Coordinator and/or designee.

Documents care coordination and progress notes in the Electronic Medical Record.

Participates in Weekly check-ins with our Medical Respite Program community partners.

Performs other job-related duties as assigned.

BASIC KNOWLEDGE:

Knowledge of health care and health care delivery systems. Analytical skills necessary to evaluate patients� concrete needs and to formulate and implement a treatment plan.

Interpersonal skills to effectively interact with patients families medical staff and outside agencies in providing services.

The applicant should have completed the Community Health Worker Certification upon hire or pursue this within one year of hire.

EXPERIENCE:

Two (2) years of experience providing information education intervention and/or referral services to culturally diverse or medically complex patient populations.

Two to three years professional experience working in health care setting or human service agency preferred.

Must exhibit strong interpersonal skills as well as a collaborative approach and style of communication in order to interact successfully on a daily basis with a wide and diverse population of health care providers community agencies patients and their families.

Experience with motivational interviewing advising/counseling clients and/or participating in health promotion and health education activities.

Experience working with health care systems substance use treatment programs and/or community-based organizations.

Must demonstrate knowledge and skill necessary to provide care to patients throughout the life span with consideration of aging processes human development stages and cultural patterns in each step of the care process.

A basic proficiency in the use of Microsoft office software programs including email Outlook calendar and basic keyboard skills are also required.

Bilingual English/Spanish preferred.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

General hospital environment with occasional stressful conditions associated with patient care.

Community and home visits required.

Must be able to make hospital rounds through various patient care areas either by walking or through some other mobile means.

Must be able to lift and or carry up to 10 lbs. to transport items from one patient care unit to the next.

If performing an assignment that requires driving must have a good driving record meet and maintain the appropriate and valid driver�s license in order to operate motor vehicles as required by the Federal Motor Carrier Safety Regulations in accordance with the Lifespan Fleet Risk Control Policy.

INDEPENDENT ACTION:

Performs independently within the department�s policies and practices. Refers specific complex problems to the manager or designee when clarification of the departmental policies and procedures is required.

SUPERVISORY RESPONSIBILITY: None