SHP Community Health Worker II

JOB SUMMARY/PURPOSE Supports Population Health clinical and operational activities with oversight and coordination with department clinical staff.
Completes care coordination activities with members/caregivers to maintain daily health functioning, prevent complications of medical conditions and utilize health care resources efficiently.
Completes assigned complex care coordination activities to support contractual requirements.
Applies knowledge of applicable regulations and benefits to identify appropriate resources (internal or community partners) and eliminate barriers where possible.
Applies expert level health plan knowledge to provide informal oversight and leadership to project initiatives, staff training and committee participation.
DEPARTMENT DESCRIPTION Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc.
(IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc.
offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.
As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS Bachelor's degree in a health-related field or equivalent experience in health care or case management required.
Two (2) years Health Care Guide or related experience required.
Community Health Worker certification required within one (1) year of hire.
Experience in Microsoft Word and Excel and electronic documentation systems required.
Medical Assistant certification preferred.
KNOWLEDGE/SKILLS/ABILITIES Effective written and verbal communication skills to perform group presentations, tactfully discuss issues and listen to and understand concepts, rules and procedures.
Ability to work with all levels within the organization, facilitate communication and effectively document related activities.
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 – 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist Location: Samaritan Health Services · SHS Health Plan Ops - Clin Ser Schedule: 1.
0 (80 hrs/pp), Day