Community Referral Specialists focus on improving health where clients live, work, and learn. They provide screenings and services, including case management, navigation, and referrals to home- or community-based services. Under the supervision and guidance of the Screening and Navigation Lead (SNL), the Community Referral Specialist is responsible for performing referral and navigation services and for facilitating community service access for one or more clinical delivery sites as part of Community Compass RI (the Integra CMS Accountable Health Communities Partnership). Additionally, the Community Referral Specialist assists with mentoring HRSN Screening and Referral Volunteers/Interns. Re
Screening Medicare and Medicaid recipients for health-related social needs (i.e., housing, utilities, transportation, food insecurity, interpersonal violence, family and caregiver support, and physical activity) at selected clinical delivery sites;
Performing, community service referral and navigation for Medicare and Medicaid recipients who screen positive for HRSN and other functions of a screener and community referral specialist, as necessary and if time allows;
Proactively identifying actual and potential screening, referral, and navigation issues and problems and proposing solutions to meet those challenges;
Working with clients to identify their strengths, manage their barriers, set and achieve their goals in meeting health-related social needs.
Assisting the SRN Lead with monitoring the HRSN Screening and Referral process, overseeing Volunteers and Interns who are executing screening and referral sponsibilities include:
activities funded by and central to the AHC grant, and monitoring performance of community service providers;
Collaborating with clinical delivery sites and community service providers;
Collecting and reporting data and documenting in the client record all communication and activity with and on behalf of the client;
Implementing and complying with Center for Medicare and Medicaid Services and Integra Accountable Health Communities Partnership policies and procedures relevant to screening, referral, and navigation;
Ensuring the timely completion of all required tasks related to screening, referral, navigation, and community access according to program plans, policies, and guidelines;
Complying with all relevant federal, state, local, and internal rules, regulations, and reporting requirements.
This position is grant-funded and dependent upon continued federal funding and the satisfactory completion of all grant requirements upon which funding is contingent.
We seek individuals with knowledge of the challenges faced by low-income Rhode Islanders, and commitment to addressing them.
Associates Degree or equivalent required..
Aptitude for assisting individuals with unmet health-related social needs as evidenced by experience or education in community health, case management, volunteer or related education and experience.
Excellent interpersonal and communication skills, empathy and a strong desire to help others.
Ability to assist diverse individuals, work independently, and develop a knowledge of statewide community service providers and programs. Ability to develop rapport with patients and families.
Ability to navigate barriers to screening and navigation that arise.
Good organizational and time management skills.
Ability to learn electronic client record systems.
Ability to speak a second language preferred but not required, Spanish and Portuguese preferred.
Must possess a valid, current state issued drivers license, have reliable transportation and proof of current auto insurance required.
CNE Internal Posting: 4-5-19 to 4-11-19
Care New England Health System