Community Health Worker

North Star Health, an FQHC comprised of multiple PCMH practices delivering team-based care in Southern VT and Southwest New Hampshire, is seeking a Community Health Worker (CHW) to be a part of our Community Health Team (CHT) and play a critical role in helping individuals access the care they need through the provision of screening, brief interventions and connections to services to address a range of needs including behavioral health services and substance use treatment, food insecurity, housing and economic assistance. Our ideal candidate will be a team player who is community-minded, an exceptional listener and advocate, with experience in meeting people where they are at and providing assistance to help them access the service they require, ideally in a healthcare or social service setting. We have positions serving our Ludlow and Londonderry Vermont health centers.

In this role you will:

• Promote and work to achieve our mission and vision to connect with and care for our community so everyone may enjoy health and wellness.
• Work as part of the Community Health Team, in collaboration with primary care, behavioral health and substance use treatment teams
• Reach out to individuals following a psychosocial assessment; foster relationships as the face of North Star Health and key point-of-contact to assist individuals in achieving goals, identifying needs, and coordinating services.
• Conduct follow-up assessments and engage individuals through motivational interviewing to identify priority needs and areas for intervention or follow up
• Identify next steps to address findings including referral to an appropriate level of care either with North Star Health or an external service provider
• Provide brief interventions as appropriate to address screening results, either directly or through referral
• Outreach to both organizations and individuals, including meeting individuals in their home and going to a variety of service locations;
• Assist in coordinating care for individuals, identifying and addressing their barriers to and social influences on good health; assist in patient enrollment, schedule appointments, assist with transportation, and follow up on care delivery.
• Collaborate with local health and social service organizations to assist them in enhancing services and addressing systemic barriers to health and social services.
• Documents all patient encounters; complete required reports; maintain electronic patient files, including referrals, releases, assessments and other documents acquired on behalf of the patient.
• Support fellow team members in answering phones and addressing patient requests and other tasks as needed.