Job Description

Health Equity And Social Connectedness For Older Adults Program

The primary goal of the Health Equity and Social Connectedness for Older Adults Program is to serve clients of the Older Americans Act (OAA) programs, with an emphasis on rural and semirural populations, to promote healthy aging in New Mexico by developing and implementing Social Drivers of Health (SDOH) interventions and increasing access to resources for improved health equity and wellbeing. Through this program, adults who are at least 55 years of age will receive comprehensive and culturally inclusive services to improve SDOH adversity among individual clients and throughout the community.

Duties

The Community Health Worker (CHW) will serve clients by assessing and identifying social needs and providing individualized navigation to services and resources for addressing SDOH adversity. CHWs also provide digital literacy training and home visits. CHWs provide services, support, and resources for improving SDOH adversity among Older Adults by engaging directly with clients at community events, scheduled appointments, or through home visits.

Responsibilities

• Responsible for establishing trusting relationships with patients and their families while providing general support and encouragement.
• Provide interventions to improve SDOH adversity among Older Adults through client services such as advocacy, navigation and enrollment, education, health services, and social-emotional support.
• Follow program model for identifying eligible clients, assessing client needs, and determining the intervention plan to meet client needs.
• Build awareness of the program through outreach, building rapport within the community.
• Develop relationships with county health councils and tribal health councils.
• Provide Digital Literacy and Internet Use training to older adults via group and individual sessions, as necessary.
• Provide home visits for clients in accordance with "Home Visit" protocols and applicable guidelines as required by the Partner Organization.
• Attend regularly scheduled meetings to ensure feasible caseload management, provide intervention and caseload reports, and follow-up on identified resource gaps.
• Handle client interactions and information in a HIPAA compliant manner.
• Complete data entry and maintain accurate records and reports for monthly evaluation submission.
• Communicate with site supervisor and/or Program Clinical Supervisor and/or Program Manager when the need for additional/urgent support is identified.
• Maintain regular contact with Program Clinical Supervisor and Program Manager to ensure necessary clinical and personal support for complex cases.
• Maintain regularly scheduled, publicized on-site hours as determined by client needs and in cooperation with Partner Organization.
• Follow-up with patients via phone calls, home visits, and visits to other settings where patients can be found.
• Be knowledgeable about community resources appropriate to needs of patients/families.
• Act as a patient advocate and liaison between the patient/family and community service agencies.
• Record patient care management information in the electronic medical record and other software no later than 24 hours after patient contact.
• Attend regular staff meetings, trainings and other meetings as requested.
• Other duties as assigned.

Qualifications

Minimum

• High School Diploma or its equivalent.
• Successful completion of a Community Health Worker formal training program.
• Complete the required certification and training specific to serving Older Adults as required by the Older Adults Program.
• Must be computer literate to effectively maintain compliance with all standards and requirements.
• Professional communication skills, such as listening well, and using language appropriately.
• Must pass required background checks and drug screenings.
• Maintain confidentiality and discretion as a rule.
• Meet specified deadlines and manage time effectively.

• Maintain a valid and unrestricted NM Driver's License.
• Must be able to use personal vehicle over course of employment.
• Maintain valid and sufficient personal automobile insurance.

Preferred

• Previous work providing in-home or community-based mental health or case management services.
• Knowledge of some medical terminology preferred.
• Experience with medically integrated mental health services.
• Demonstrated interest in rural and community health.
• Fluency in English and Spanish, both verbal and written.

Level And Degree Of Supervision

Supervised by the Program Supervisor with clinical supervision provided by the Director of Community Services. Supervision includes two hours per month clinical supervision, participation in monthly general staff meetings, community partner meetings, and Guidance Center of Lea County staff with inclusion of others, as needed.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.
• Hearing and vision abilities within normal range (corrected) to drive safely and to observe and communicate with passengers.
• Must be able to assist passengers when needed.

Conditions Of Work

Hiring and promotion will be accomplished in compliance with the Guidance Center of Lea County's Personnel Policies and Procedures. This position is non-exempt under the Fair Labor Standards Act and requires a minimum of 40 hours per week. Hours and/or days may vary according to need. Overtime (time and ½) will be paid for hours worked in excess of 40 hours per week. Travel is required of employees for delivery of services, trainings, or conferences. Personal transportation is necessary.

Guidance Center of Lea County, Inc. is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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