Job Summary

This position provides a variety of client support functions which contribute to the overall improvement in clients healthcare quality of life as well as efficient use of resources. Provides client care to promote client comfort and contribute to the overall client plan of care. This position is primarily focused on being a client advocate, cheerleader and support to the client and family. This position is responsible for on-going client data collection and documentation in the medical record.

Essential Functions

• Reinforce clients care plan and discharge instructions, medication adherence, vital sign data collection as needed and use of in home IAC tools.

• Provides self-management support. Including but not limited to: using checklists and escalating as prescribed by protocols, promoting healthy behaviors, imparting problem-solving skills, and assisting with the emotional impact of chronic illness, providing regular follow up and encouraging people to be active participants in their care.

• Applies the skills of motivational interviewing to promote the above lifestyle changes. Provides emotional support by showing interest, inquiring about emotional issues, showing compassion and teaching compassion.

• Assists patients in navigating the health care system by connecting the client with resources, facilitating support and empowering the patient.

• Recognizes and reports abnormalities and/or changes in the clients health status and responses to treatment to a licensed professional. Promotes continuity of care by accurately and completely communicating to other caregivers the status of patients for which care is provided.

• Conducts client home environment checklist, provides list of gaps to licensed professional and works with the health care team to coordinate to close gaps/issues. Bridges gaps between the client and the clinical team including but not limited to following up with clients, asking about needs and obstacles, and addressing health literacy, cultural issues and social-class barriers.

• Reinforces activities of daily living and completes necessary tasks to promote client health, including maintaining an optimum level of mobility.

Minimum Qualifications

High school diploma/GED or equivalent working knowledge. BLS required for all new hires to the position after July 19, 2015. Incumbents in the position as of July 19th must possess their BLS certification by January 1, 2016. Must possess diverse clinical knowledge and technology aptitude as normally obtained through the completion of a Medical Assistant, Nursing Assistant or Community Health Worker program or Nursing students completing the first year of training.

Current C.N.A., CHW, or M.A. license in state of practice may be required in certain facilities and/or departments in accordance with regulatory requirements or facility/department policy. Working knowledge of medical terminology. Requires the maintenance of familiarity with clinical care processes and clinical technology and Electronic Medical Records.

Must have highly developed interpersonal and critical thinking skills with the ability to prioritize needs rapidly. This position requires the ability to convey messages and thoughts clearly to a diverse audience, using both verbal and written mediums. Requires the ability to promote change among patients. Responsible, caring and respect for older persons. Requires the ability to coordinate information and activities, work under stress of deadlines and frequent interruptions, and to possess analytical problem solving skills. Must possess excellent organizational skills, as well as effective human relations and communication skills. Computer literacy and keyboarding skills is required. Must be proficient in the use of system office applications. Must possess a basic understanding of integrated clinical systems. Provide own transportation, required to posses a valid drivers license and be eligible for coverage under the companys auto insurance policy.

Preferred Qualifications

Current BLS certification. Recent healthcare experience. Previous motivational interviewing skills preferred. Multilingual a plus.

Additional related education and/or experience preferred.