Shift Schedule: Monday - Friday 8:00AM - 4:30PM

Location: Baltimore Washington Medical Center

General Summary

The Community Health Advocate will be responsible for helping patients and their families to adopt healthy behaviors and navigate /access community resources. As a priority, will actively promote, maintain, and improve the health of patients and their family by providing services such as blood pressure screening and completing social need assessments. Supports medical providers through an integrated approach to care management and community outreach by providing social support and informal counseling, and advocating for individuals and their community health needs. Community outreach, such as home visits and health screenings, may be required.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Acts as a patient advocate and liaison between the patient/family and community service agencies (i.e. Healthcare providers, support groups, etc.)

2. Schedules clients for appointments with health care providers. Reminds them of pending appointments and contacts them to inquire into reasons for missed appointments. Escorts clients to or calls clients to confirm various appointments to ensure compliance and provide support.

3. Conducts intake interviews with patients, including enrolling into health plans and/or referring patients to healthcare provider.

4. Provides referrals for services to community agencies as appropriate. Be knowledgeable about community resources appropriate to needs of patients/families.

5. Provides general information to individuals and families on program objectives and services, eligibility requirements and benefits, confidentiality of information, etc. Distributes informational materials and literature.

6. Responsible for establishing trusting relationships with patients and their families while providing general support and encouragement.

7. Provides ongoing follow-up with patients via phone calls, home visits and visits to other settings.

8. Works closely with medical provider to help ensure that patients have comprehensive and coordinated care. Follow-up with patients should be continuous from initial identification through closure.

9. Responsible for providing consistent communication to the Care Management Team.

10. Serves as coordinator to evaluate patient/family status, ensuring that provided information, and reports clearly describe progress.

11. Records patient care management information in the EMR (training provided) and other software no later than 24 hours after patient contact.

12. Continuously expands knowledge and understanding of community resources and services. Facilitates client access to community resources, including locating housing, food, clothing, transportation and providers to teach life skills, and relevant services.

13. Serves as a liaison between the client and community resources including department staff, City, State and Federal social services agencies.

14. Attends regular staff meetings, trainings, and other meetings as requested

15. Manages assigned caseload of patients.

16. Assists with planning, organizing and implementing community special events such as health fairs, workshops, etc.

17. Other duties as assigned.