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TX STAR+PLUS Community Health Worker

Primary Location: Houston, TX
Additional Locations: TX-Baytown, TX-Champions, TX-Conroe, TX-El Campo, TX-Galveston, TX-Houston, TX-Lake Jackson, TX-League City, TX-Missouri City, TX-Pasadena, TX-Pearland, TX-Sugar Land, TX-The Woodlands
At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas STAR+PLUS, STAR/CHIP, and STAR Kids members. We value diversity and are dedicated to helping you achieve your career goals.

Community Health Care Workers (CHW) serve the community as a bridge between the member (community) and the healthcare system (providers) through outreach and education. By providing these services, CHW’s help Aetna members attain and maintain better health outcomes, improve relationships with healthcare providers and help both parties to become more acculturated with each other. This position will work under the direction of a designated professional. This position requires travel up to 60% of the time, with use of a personal vehicle. Occasional weekend hours may be required.

Fundamental Components:
Conduct home visits with Aetna members with chronic conditions to reinforce following the care plan, adjusting tasks to fit with the member’s culture, language, and religion, improve access to care, identify health care needs, and reduce unnecessary hospitalizations. Educate healthcare professionals and providers on opportunities for improving and understanding the social determinants of health that may be impacting member’s health and treatment plan through various communication channels. Build and maintain positive working relationships with the Aetna members, providers, nurse case managers, agency representatives, supervisors and office staff, from diverse cultural and socio-economic backgrounds. Work to reduce cultural and socio-economic barriers between clients and institutions. Assist with care plan implementation and Aetna member education during in-home visits, help develop care management strategies, and work with team members to provide linkages for the various health and social needs of members. Assist members to identify socio-economic issues that affect their overall health and develop health/social management plans and goals. Identify gaps and opportunities to strengthen systems of care within the member’s community and assists members in utilizing community services, including scheduling appointments with social services agencies, (including transportation vendors), and assisting with completion of applications for eligible programs. Assist with patient medication adherence by: instructing the member on current medication list, reviewing medications with member and assist in obtaining refills. Teach disease self-management (i.e. nutrition, symptom tracking and reporting). Accompany members to appointments as needed. Enter and maintain member records in electronic health record system, compile reports and complete other program documentation in a timely manner (e.g. progress notes, letters), and other administrative responsibilities as needed. Assists in connecting with members when care team is unable to reach members. Travels extensively to client homes, community locations, various agencies, and other outreach destinations.

Background Experience:
Preferred skills:
  • Mental Health First Aid, Trauma Informed Care, HIPPA, C.L.A.S. Standards, Motivational Interviewing, and specialized training in medical terminology and practices for designated health conditions.
  • Experience in serving the Medicaid Populations in urban or rural environments with familiarity of local formal and informal resource networks preferred.
  • 1-2 years’ experience providing clinical services; experience in community/outpatient setting preferred.
  • Community Health Worker Certification or equivalent training and experience preferred.
  • Bilingual skills preferred (Spanish).
  • Experience using a computer including the use of Excel and Electronic Health Records.
  • Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications.
  • Meet all requirements set forth by local state i.e. first aid, CPR, TB screen, etc. 3-5 years relevant experience.
  • Completed and approved CHW/Promotora certification program.
  • High School Diploma or G.E.D.

Additional Job Information:
  • HARRIS SERVICE AREA: Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller and Wharton counties.
  • Requires flexibility to work in situations in which the working conditions are unknown, as environments and situation of patient homes may vary.
  • Ability to communicate medical information to health care professionals and care coordinators over the telephone.
  • Knowledge of formal and informal community agencies and resources. Working knowledge of multi-system outreach programs related to health care delivery, clinical education, and health-related services.
  • Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
  • Requires the ability to travel to multiple office locations and home locations,
  • Able to influence medical care providers as needed to adjust interventions based on member’s cultural, ethnic, or religious preferences.
  • Ability to work collaboratively in a team and manage multiple priorities, utilizes effective time management skills, and exercise sound judgment.
  • Exceptional organizational and interpersonal skills, with attention to detail required.
  • Ability to effectively provide support care to socially and medically complex patients in a variety of non-traditional settings.

Required Skills:
Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Interacting with Medical Professionals, General Business - Applying Reasoned Judgment

Desired Skills:
Benefits Management - Understanding Clinical Impacts, General Business - Communicating for Impact, Leadership - Collaborating for Results

Functional Skills:
Medical Management - Medical Management - Clinical coverage and policies, Medical Management - Medical Management - Direct patient care, Medical Management - Medical Management - Non-profit Community Health Center

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Potential Telework Position:

Percent of Travel Required:
50 - 75%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.


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