Lead Specialist - Combest NAV Program CHW

Performs advanced, specialized work to assist in the organization and implementation of various projects and programs. Work is performed under minimal supervision within established policies with latitude for independent judgment. Works on special projects as assigned. May substitute for supervisor during his/her absence.

Major/Essential Functions

• Will establish close working relationships with patients and members of an interprofessional team to identify non-medical drivers of health and reduce health disparities.
• Promote goal setting and strategic planning for the betterment of overall wellness.
• Accepts referrals and provides case management for Children and Pregnant Women (CPW), and chronic disease management for IPCP.
• Assesses healthcare needs to provide care coordination, tailored health educ and identifies community resources.
• Serves as patient advocate and assists in identification and improvement of service delivery requiring expertise in critical thinking skills to plan and coordinate care.
• Documentation of case management activities in the electronic health record.
• Assist in the organization and implementation of various projects and programs.
• Perform work under minimal supervision within established policies with latitude for independent judgment.
• Works on special projects as assigned.