Community Health Partner - MD
Core
Community Health Partner supporting members with complex social, behavioral, and physical needs through in-home visits, care coordination, and navigation of community services.
Role type
Mid-level community health coordinator (non-clinical)
Builds
Integrated social care coordination for members with complex needs
Domain
Healthcare + Social Services
Required skills
Care coordination, Motivational Interviewing, Trauma Informed Care, case management, community resource navigation, data documentation, risk mitigation, preventative care education
Preferred skills
Experience with high-volume caseloads, creative problem solving in healthcare systems, adaptability to fast-paced changes
Technologies
Electronic health records, care facilitation platforms, scheduling platforms, telehealth/virtual visit platforms
Responsibilities
Conduct in-home and virtual visits to assess member needs and coordinate care; Complete behavioral health assessments and screening instruments; Develop and update care plans with RN Care Managers; Coach members to achieve care plan goals and activate them for preventative care; Participate in case conferences and support loop closure on internal referrals; Document member interactions and track tasks using EHR and scheduling systems.
Seniority
Mid-level, hands-on IC