Apply on line at http://www.alohacare.org/Careers/Default.aspx
The Company
AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage to successfully build
a healthy Hawaii.
The Culture
AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication, and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect, and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.
These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.
Position Summary
The primary role of the High-Risk Pregnancy (HRP) Community Health Worker is to identify pregnant members at high risk and establish relationships with both these members and their providers. They work to engage them in AlohaCare’s High Risk Pregnancy Program, aiming to enhance the health outcomes for both the mother and baby. The HRP Community Health Worker will educate and assist actively enrolled AlohaCare HRP members on how to navigate their health plan benefits. The HRP Community Health Worker assists with completing the administrative sections of assessments, coordinating transportation, addressing gap closures, and making community referrals for our members. The HRP Community Health Worker will spend most of their time identifying members for the program and conducting face-to-face or home visits in community or facility settings. This includes accompanying them to provider appointments, locating members who have been unengaged with the health plan, and coordinating services in collaboration with the High-Risk Maternal Child Health Program Manager or under clinical supervision in various settings such as the field, hospitals, or community health centers.
Primary Job Duties And Responsibilities - Perform initial outreach to conduct education and welcome call as needed.
- Engage members and providers in the assessment process.
- Escorting member to and from appointments as appropriate
- Assisting with completing Self-Direction application
- Electronic Visit Verification (EVV) training and troubleshooting
- Meet members as required by standards set by Medicare, Medicaid, or the organization.
- Check in with member for months one, two and so on, in person or via video chat (member’s preference) to monitor and document the Member’s progress and provide feedback to GRACE team.
- Under clinical supervision, when required, the CHW interacts with member, family, physician(s), and other providers to assist in determining the member’s status and capacity and to assess the options for service delivery including use of health plan benefits and community resources to update a Member’s Health Action Plan.
- Identifying and providing transportation assistance, if needed, etc., on behalf of the member and provider.
- Conduct issue resolution related to the goals of the Health Action Plan or other program benefits. Support member redetermination efforts and initiate enrollment into other program benefits based on eligibility.
- Conduct post discharge follow up for members assigned by High-Risk Pregnancy Program Manager.
- Collaborate onsite at Community Health Centers and other provider offices to support their AlohaCare patients with care coordination needs to improve health outcomes.
- Assist with picking up and delivering Durable Medical Equipment, baby car seats or prescriptions as needed.
- Follow up calls on DME and other referrals and receipt of services.
- Assist members in completing forms/applications and other necessary documentation for other programs that can assist the member.
- Benefit applications (i.e. SNAP and financial)
- Social Security Income application
- Social Security Disability Income application
- Connect/Refer members with Social Determinates of Health (SDoH) needs to Community Resources in their neighborhood or area or utilizing the Unite Us tool.
- Assist with coordination of appointments for members.
- Assist the member in maintaining eligibility and connections with other entitlement programs the member may qualify.
- Coordinate with AlohaCare High Risk Maternal Child Health Program Manager, and appropriate operational departments/units, as required by the member’s needs (e.g., Utilization Management, Transition of Care, Disease Management, Service Coordination, Travel, etc.), and network physicians/providers to ensure specialty services are in place (when applicable).
- Promote positive health outcomes by ensuring members receive comprehensive annual physicals and preventive services.
- Arranging and coordination interpreters and/or transportation for medical appointments.
- Assist with researching and correcting accurate contact information for outreach efforts
- Complete scheduled and assigned daily activities on the activity log within the Health Edge Guiding Care Management system. Document Service Navigation activities in the Health Edge Guiding Care Management system
- Assist the members with translation services and enabling services and coordination of medical benefits, including providing coordination assistance with other Medicaid QI Health Plans.
- Perform member outreach calls for targeted prenatal and postpartum care appointments, under the direction of the Director of Population Health Management.
- Other duties as assigned by supervisor and/or manager.
- Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Required Competencies & Qualifications
- High School Diploma
- Minimum one (1) year Member Outreach, Care Coordination, Managed Care, Health Care and or previous Health Plan with direct member support experience.
- Experience with serving members in the community.
- Health plan experience with care coordination responsibilities
- Strong verbal and written communication in English.
- Requires operation of general office equipment to include PC, Surface Pro 3, fax/copy machine and company phone. Intermediate skill using Microsoft Programs; Word, Excel, Outlook, and PowerPoint.
- Possession of a valid driver’s license and auto insurance with access to a reliable, 4-wheel, safety- inspected vehicle.
- TB Clearance
- First Aid and CPR Certification
Preferred Competencies & Qualifications
- Bachelor’s Degree in Human Services, Sociology, Psychology, or other related field.
- Bilingual in Ilocano, Tagalog and/or Korean preferred.
- Experience with individuals who have special health care needs, including HIV/AIDS, developmental disabilities, medically fragile, older adults, and individuals with physical disabilities.
- Ability to complete multiple tasks to ensure timeliness standards are met.
- Associate degree or previous equivalent healthcare experience preferred.
- Three (3) years of Care Coordination, outreach, and customer experience
Physical Demands/Working Conditions
- Medium work: Walking, standing, and exerting up to 40 pounds of force occasionally, or up to 25 pounds of force frequently, or greater than negligible up to 10 pounds of force constantly to move objects.
- May require prolonged sitting up to 4 hours.
- Requires operation of a computer workstation, including keyboard and video display terminal.
Salary Range: $24.00 - $32.00 an hour
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.
