CAREERS

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Program Manager

Position Available: Program Manager

Location: Northern Virginia – Region 2

Reports To: CEO

Job Status: Exempt, Full‐time

Benefits: Health and Travel benefits support

Salary: $80,000-110,000 DOE

 

Job Objective – Provide oversight and direction of regional program, including coordination of care delivery efforts of team members, program administration, and coordination of data collection and reporting, among other duties. Program Manager supervises is also expected to be involved in care coordination activities including Supervisors Community Health Workers.

 

General Job Description, Qualifications and Responsibilities – The position involves direct interaction with high utilizers of community services to improve their overall care and mitigate crisis events. The program manager engages with patients as well as their current providers and conducts an extensive review of recent medical care, including but not limited to recent emergency department visit records and recent hospital admission records. Program enrollees are often engaged with multiple community resources to provide improve care and resource allocation for the patient’s issues of concern. The program manager interacts with patients, primary care providers, medical specialists, social service entities and other community resources to provide an improved care plan for enrolled patients. The program manager oversees creation an individualized care plans for each patient and distribute these amongst appropriate community members in a HIPPA compliant fashion and using contracted local and regional resources. The program manager oversees continued engaged with patients throughout their enrollment, including contact after each ED visit and with assistance in obtaining targeted community resources as determined necessary.  RN or MSW experience with complex care patients is helpful.

The Program Manager oversees the entire team in the region, including community workers, office staff, and additional care coordinators that may be needed (depending on volume of clients being managed). The Program Manager is responsible for fostering a strong team dynamic amongst all staff.

The Program Manager is ultimately responsible for managing community interactions, including managing and addressing complaints, data collection and reporting, and staff hiring, orientation, and discipline.

While most activities will be conducted during pre-determined shift hours, there may be occasional demands for after-hours work. As the leader of the local program, the Program Manager will be responsible for managing after-hour requests of/from local staff. The Program Manager reports directly to CBCS administrative leadership.

 

List of Duties – The list of duties for the position include, but are not limited to, the following:

  • Oversight of all local patient engagement efforts
  • Oversight of all Care Plan creation
  • Oversight of local Community Workers and additional program staff
  • Delegation of cases and specific tasks to community workers
  • Create weekly duty list for each community worker
  • Assure weekly assignments and case assignments are up-to-date
  • Coordination of home visits
  • Engagement of community members involved in patient’s care
  • Outpatient providers (Primary care providers and specialists)
  • Hospital providers (ED providers, hospitalists, social workers and discharge planners)
  • Community resources, including but not limited to
  • Law enforcement personnel
  • EMS providers
  • Behavioral health providers
  • Chemical dependency providers
  • Jails
  • Housing authorities
  • Adult and child protective services
  • Involvement in local and regional Multi-Disciplinary Team meetings as appropriate
  • Involvement in local and regional community events upon request
  • Coordination of community educational efforts related local program
  • Serve as point-of-contact for local/regional High Utilizer IT system
  • Oversight of these efforts if these duties are delegated in any way
  • Oversight and management of data collection for the local market
  • Participation in hiring and orientation of community staff members
  • Oversight of team communications with off-hours staffing group
  • Ability to work directly with clients that may be suffering from any number of psycho-social issues including, but not limited to, mental health disorders, substance abuse issues medical issues, and homelessness.
  • Carry out work duties in a confidential and respectful manner, even when under stress.
  • Assure appropriate documents are signed by patient at time of enrollment
  • Release of Information
  • CBCS Policy on Unencrypted Texting and Emailing

Key Functional and Relational responsibilities

  • Be available to enrolled clients during typical working hours
  • Oversight of after-hours issues
  • Development of care plans for assigned enrolled clients
  • Create functional team environment with CBCS staff
  • Engagement of assigned clients and associated providers and community resources
  • Work with team to create appropriate list of monthly clients
  • Report monthly data to CBCS team for incorporation into monthly scorecard report
  • Interact with MDT to assure that appropriate information is available for clients being reviewed at bi-monthly meetings
  • Be easily available to ED providers and local PCPs upon request
  • Work with local law enforcement and EMS personnel on targeted community direct interactions with enrolled clients
  • Engagement with local IT resources upon request

Relationships and Roles within the Organization

  • Work directly with local CBCS staff in a team-based model of care
  • Report to organizational leaders on a weekly basis
  • Assist in submitting reporting data to organization on a monthly basis

To apply, please send a resume and cover letter with salary requirements to jobs@cbc-solutions.org.

Community Health Worker

Position Available:       Community Health Worker

Location:                         Northern Virginia (Region 2)

Reports To:                    Program Manager

Job Status:                     Exempt, Full‐time

Benefits:                         Health and Travel benefits support

Salary:                            $18-22.50/hour DOE

 

Position Summary

The CHW coordinates community and other resources to improve health care delivery for a complex patient population. The position includes significant field time with a variety of direct patient engagement duties including:

  • conducting initial intake assessments and risk reduction interventions
  • assistance/coordination with access to resources
  • assistance coordinating transportation and housing as needed
  • engagement during crisis periods
  • resource engagement and allocation
  • regular meetings with clients’ care-teams

The CHW works as part of a team under the direction of a Program Manager. The position involves direct interaction with individuals deemed to be high utilizers of community resources to improve their overall care and help mitigate crisis events. The community health worker will be interacting with patients, primary care providers, medical specialists, social service entities and other community resources to provide an improved care plan for enrolled individuals. Enrolled individuals have typically been identified as “complex,” and most struggle with issues of homelessness, substance abuse and/or mental health.

Qualifications

This job requires the ability to demonstrate patience and understanding with this high medical and behavioral needs cohort, and the ability to navigate and assist clients with a number of challenging medical and social issues. While most duties will be conducted during pre-determined office hours, there will be requests for off-hours work.

We emphasize the following traits for this position:

  • Desire and comfort working directly with at-risk individuals
  • Lived experience with issues of homelessness, substance abuse, and/or mental health
  • This position does require local travel, and a valid driver’s license drive is required; access to your own reliable transportation is preferred.
  • Basic computer access, intake and filling skills. Ability to access electronic information and participate in virtual meetings via tools such as Zoom.
  • Ability to attain local CHW Certification within 6 months of hire is preferred.

Skills

Preferred skills for the position include, but are not limited to, the following:

  • Patient engagement
  • Performing intake assessments
  • Maintaining frequent patient contact including reminders of appointments; assistance/encouragement to appointments
  • Engaging individuals after each emergency department and/or primary care visit
  • Assisting clients in finding resources (housing; transportation; food; care)
  • Note – Many of the duties will be customized depending on the needs of each individual patient
  • Ability to work directly with clients that may be suffering from any number of psycho-social issues including, but not limited to, mental health disorders, substance abuse issues, chronic medical conditions, and homelessness.
  • Carry out work duties in a confidential and respectful manner, even when under stress.
  • Care Plan creation and maintenance
  • Engagement of local/regional Electronic Medical Records in a HIPPA compliant fashion
  • Attending local community meetings as needed
  • Engagement of community resources involved in patient’s care; this may include (but is not limited) to resources such as:
  • Emergency Department personnel
  • Primary Care Providers and Specialists
  • Law Enforcement agents
  • EMS personnel
  • Behavioral Health Centers
  • Substance Abuse Treatment Centers
  • Therapeutic Courts
  • Jails
  • On-Call providers
  • Housing Authorities
  • Other community care coordinators and/or agencies

 

Positional Roles and Responsibilities

  • Member enrollment into program – this will typically involve phone and direct home and/or field-based contact with members during the enrollment process.
  • Create care plans for enrolled members.
  • Assist members in a variety of activities in-home and community-based services, which may include assistance scheduling appointments, assist with travel to/from medical appointments, and engaging providers and community resources as needed.
  • Problem-solve with members their barriers to care and establish with members their goals of care.
  • Be available after hours (through a rotational call schedule) for emergent member needs.
  • Work with team to create monthly client enrollment lists.
  • Work with a variety of local resources, including (but not limited to) law enforcement, EMS, housing, medical, treatment, jail, food/clothing, and a variety of governmental agencies in development of ideal member enrollment plans. Participation in community multi-disciplinary teams as needed.
  • Timely and accurate documentation of practices as per organizational policies and procedures

 

Organizational Roles and Relationships 

  • Adhere to organizational values and policies.
  • Actively participate in organizational performance improvement activities
  • Report directly to Program Manager
  • Work in a team-based model of care
  • Perform other duties on an as-needed basis
  • Report to organizational leaders upon request
  • Assist in submitting reporting data to organization as needed
  • Protect client personal health information by compliance with HIPPA and additional relevant health-care IT related regulations.

To apply, please send a resume and cover letter to jobs@cbc-solutions.org.

CBC Solutions is an equal opportunity employer and will not tolerate discrimination based on race, color, religion, sex (including pregnancy, sex stereotyping, gender identity, gender expression or transgender status), national origin, sexual orientation, physical or mental disability, age, protected genetic information, status as a parent, marital status, political affiliation, or retaliation based on prior protected EEO activity.