• Finds and engages with clients in the community to assess risks, eligibility for services, and provide referral information. Communicates with clients in-person, by telephone, electronically or by mail.
• Documents in a timely and accurate manner all encounters, referrals, and follow up in the SIMS database.
• Tracks client progress towards identified outcomes with community agencies and assist in obtaining services required for risk reduction.
• Maintains knowledge of available community-based resources and programs to assist in meeting client needs.
• Meets clients at minimum, monthly for appointments. Assists in scheduling and accessing health and service appointments for client as needed.
• Assists in ensuring that services provided yield the expected outcomes through education, communication, collaboration, and client advocacy, while preserving confidentiality.
• Acts as a liaison between the client and care team to support and provide resources for individuals
• Accompany clients to appointments as needed.
• Follow through on assigned quality (QA) assurance activities.
• Provides support and educational activities for clients in order to promote health knowledge, self-sufficiency, self-care and to assist individuals in developing skills related to better health. Educational activities include but are not limited to: community resources, health education, social support, and daily living skills.
• Motivates clients to be active and engaged in their health.
• Plays a consistent and active role in identifying project inefficiencies and finding collaborative solutions to the problems.
• Identify and apply appropriate role definition and skilled boundaries
• Maintain skill and competence levels by attending department/staff meetings, Community of Practice meetings, and by participating in continuous training as required and appropriate.
• Maintain confidentiality of client-related information and maintain respectful treatment of clients.

Education: High School graduate; some college preferred.

Certifications: Peer Support Specialist or Community Health Worker certifications preferred. Willingness to obtain if not already certified.

Experience: Minimum one-year working or volunteering in human services, healthcare, community outreach, health education, or related direct service.