Community Health Partner

Company: Cityblock Health
Location: High Point
Posted on: May 3, 2021

Job Description:

Cityblock Health is the first tech-driven provider for communities with complex needs"bringing better care to where it's needed most, block by block. Founded in 2017 on the premise that "health is local" and based in Brooklyn, we are backed by Alphabet's Sidewalk Labs along with some of the top healthcare investors in the country. Our mission is to improve the health of underserved communities, one block at a time. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams. In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve. Over the next year, we'll grow quickly to bring better care to many more members and their communities. We will get started in new markets, each with their own operating structure and care teams, and continue to grow in the communities where we are working already. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community. Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community. Our Values: Aim for Understanding Be All In Bring Your Whole Self Put Members First About our Team: We employ a field-based, home-based care model and are committed to meeting members where they are--in their homes, in their community, and in our Hubs. You will go above and beyond to connect with members in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day. About the Role: You will work in a radically different model of healthcare. You will be on a large team of Community Health Partners. Expect collaboration, shared-decision making, and partnership across clinical and non-clinical care team members. Cooperatively manage care for a population living with complex medical and behavioral health needs. Steer a care team, constantly communicating with other team members and members around their needs and health goals. Foster lasting and trusting relationships as the face of the team and key point-of-contact to assist members in achieving goals, identifying new needs, and coordinating care. Meet with members in their homes, neighborhoods, and throughout the complicated paths of the healthcare system. Coordinate care for members, identifying and addressing their barriers to and social influences on good health. Work daily within our custom-built care facilitation platform, which will enable you to collect data, organize information, track tasks, and communicate with staff, patients, and family members. This platform is being built for a mobile workforce. You will have the opportunity to provide feedback to the product development team and co-design a platform that fits team needs, and over time you may become part of a super-user group to assist in onboarding and supporting others. Requirements for the Role: You have experience with patient navigation, management, or any kind of direct service provision. You have a passion for working within the community you are a part of, or have been a part of in the past. You are flexible, team-oriented, and willing to wear many hats You will jump in and support outreach efforts in partnership with our Outreach Specialist team as you build your member panel Work a full-time 40 hour week, Monday-Friday 9am to 5pm ET with the occasional Saturday shift. Your work may take you outside of normal business hours as urgent member needs arise. You are experienced in documentation of member action plans, care planning, care coordination and have excellent writing skills You excel at empathy and human interactions, and want to improve the health of individuals and whole communities. You are an independent self-starter and a strategic thinker who is eager to learn, improve, and grow. You are excited about how technology can support your work and help drive the ongoing evaluation toward new, better, care. Unrestricted Driver's License and Vehicle for daily use How We Define Success: Member Panel - Increase your caseload after joining Cityblock as you add members to your panel. CBH engagement - Successfully consent new members by meeting enrollment targets within 90 days and 9 months of attribution. Health Plan engagement - Through outreach, engage members by phone or unscheduled visits with the goal of engaging 55% within 6 months of attribution and 85% within 12 months Initial Assessment - Complete initial assessments 75% of members within 45 days of consent Active MAPs - Ensure active Member Action Plans for 75% of members within 60 days of consent. Advanced Care Planning - Document advance care planning in Commons for 95% of members within one year of consent Transitions of Care - Partner with Care Team to ensure that expectations and targets for transitions of care are met. After discharge from inpatient, emergency or observation in medical facilities, this may include Cityblock clinician visits, connections with others on the Care Team, or medication reconciliation within specified time frames. Member Communications - Answer the majority of phone calls from members that are received during business hours. Member Tends - Percent of enrolled members who receive acuity-appropriate interactions with the Cityblock team Net Promoter Score - Support high engagement with Cityblock (measured using NPS) among members Nice to Have, But Not Required: Experience working with individuals with mental health and substance use diagnoses. Training in motivational interviewing, behavioral activation therapy, or problem solving treatment. Direct familiarity with clinical settings. What We'd Like From You: A resume and/or LinkedIn profile A short cover letter, please! Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. - We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means. Are you legally authorized to work for Cityblock in the United States? * Will you now or in the future require Cityblock to serve as a sponsor for employment (e.g., H-1Bvisastatus)? * Pease list any languages (other than English) that you are fluent in Have you worked for Cityblock, or received an offer in the past? * This question will help us to filter in-bound candidates who have worked for Cityblock before, or may have received an offer. LinkedIn Profile Website Which hub location(s) in North Carolina do you want to be considered for? * Winston-Salem High Point Greensboro Charlotte Fayetteville Confidential Diversity & Inclusion Survey We take equal opportunity seriously here at Cityblock and are working to build a company that is as diverse as the communities we serve. Completing this survey is voluntary , but we hope that you will choose to answer. All responses are kept completely private - they cannot be seen by anyone reviewing your application, they are not used for or against your candidacy in any way.Because the EEOC identifying questions are limiting, we would like to provide more options to our candidates to self identify for their gender, race, and age. Our work here at Cityblock is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with building a diverse and inclusive team. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community. Individuals seeking employment here at Cityblock are considered without regard to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation. And, because we do business with the government, our recruiting and hiring practices must meet affirmative action and equal employment opportunity standards. Part of this is inviting applicants to self identify, which allows us to comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements. Thank you! Toyin, Iyah and Bay Co-Founders, Cityblock Health What age group do you belong in? 18-20 20-30 30-40 40-50 50-60 60+ What gender group do you identify as? Cis-Male Cis-Female Non Binary Trans Woman Trans Man Other (Open Comment) What race do you identify as? African-American / Black Hispanic / LatinX Caucasian / White East Asian (including Chinese, Japanese, Korean, and Mongolian) Native American/Alaskan Native Middle Eastern Pacific Islander South Asian (including Bangladeshi, Bhutanese, Indian, Nepali, Pakistani, and Sri Lankan) Southeast Asian (including Burmese, Cambodian, Filipino, Hmong, Indonesian, Laotian, Malaysian, Mien, Singaporean, Thai, and Vietnamese) Prefer Not To Answer Other (Open Comment) U.S. Equal Opportunity Employment Information (Completion is voluntary) Individuals seeking employment at Cityblock Health are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation. You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file. Gender Are you Hispanic/Latino? Race & Ethnicity Definitions If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Veteran Status Form CC-305 OMB Control Number 1250-0005 Expires 05/31/2023 Voluntary Self-Identification of DisabilityWhy are you being asked to complete this form? We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years. Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at . How do you know if you have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. 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Keywords: Cityblock Health, High Point , Community Health Partner, Other , High Point, North Carolina