Job Description
The Bedford-Stuyvesant Family Health Center (BSFHC) is a Federally Qualified Health Center (FQHC) that serves all of the primary health care needs of families in the heart of North and Central Brooklyn. Our mission is to provide the most professional, courteous and highest quality health care, with dignity, to those we serve, especially the undeserved population, without regard for ability to pay. In addition to operating the Health Centers, we operate in School-Based Health Centers to increase the accessibility and availability of quality primary and preventive physical and mental health care to pre-school, elementary, middle and secondary school students in high-risk areas of Bedford-Stuyvesant, Brooklyn. Position Summary Health Coach primary responsibility is to engage patients/ participants in collaborative relationships, empowering them to manage their chronic diseases and environmental health to improve and maintain their well-being that leads to life-long healthy changes. This includes patient assessment for the Health Home At-Risk project and Health Home eligibility, care planning, facilitation of population health management, coordination of care for patients on caseload, patient education, patient advocacy, and regular evaluation of patients on caseload. Duties And Responsibilities Include But Not Limited To - Contact and performs initial interviews with individuals who are eligible for health coaching program.
- Provide coaching to reduce or eliminate behaviors that are considered high risk in participants with chronic diseases, such as Diabetes, Hypertension, Asthma and Hyperlipidemia.
- Uses registries to identify patients with newly diagnosed, undiagnosed or poorly controlled chronic conditions and schedules follow-up appointments.
- Conducts outreach to patients with overdue screenings or upcoming appointments
- Performs intake and assessment of patients with newly diagnosed or poorly controlled chronic conditions, screens for Health Home eligibility, and checks Health Home enrollment
- Screens for behavioral health and substance use problems, including depression (PHQ), alcohol abuse (AUDIT), substance abuse (DAST) and smoking status.
- Reinforces education provided by PCP or nurse on management of the chronic disease, provides self-management tools, and reviews how to use those tools.
- Establishes goals and creates a care plan.the patient, Works with patient to mitigate impacts of social factors on health and functional status, e.g. by arranging transportation for patients.
- Does post-visit review of next steps with patient.
- Coordinates care, assists with referral management, and conducts between-visit monitoring and outreach.
- Tracks and follows-up on test results to ensure patient and caregiver take appropriate next steps.
- Serves BSFHC's first point of contact during post-discharge care transition from hospital or emergency department.
- Works with DSRIP Coordinator and practice's performance improvement team.
- Assists in scheduling huddles and other internal team meetings.
Education/Experience Required - Bachelor’s degree in health science, counseling, psychology, nutrition, social work or a related field. Master’s degree preferred.
- Strong background in nutrition preferred.
- Certification from the National Board for Health and Wellness Coaches (NBHWC) required.
- Minimum of 2 years’ experience as a health coach, including conducting one-on-one and group coaching.
- Strong background in health promotion, chronic condition management, and behavior change methodologies.
Other Related Skills/Experience And Requirements - Must be flexible with scheduling
- Maintain HIPPA patient/employee confidentiality
- Knowledge of EMR systems a must
- Bilingual ability a plus.
- Excellent interpersonal skills must demonstrate professionalism, courteous and respectful attitude in dealing with patients, team members, families and significant others
- Display courtesy, tact and patience with all members of the team members and extended community
- Ensure that all patients and visitors receive personalized prompt attention and are treated with receptiveness, dignity and respect
- Provide instructions to the patient upon discharge as per instructed by the providers
- Strong organizational skills and ability to think clearly and to work in a busy clinic.
- Strong skills in a Microsoft Outlook and Word
- Excellent verbal and written communication, and time management skills
Salary Range $25 per hour
Benefits Overview: We offer attractive compensation with comprehensive benefits including Profit Sharing Plan, Medical, 401(k), and Long-Term Disability, Transportation Plan, Generous Paid Vacations and Holidays.
BSFHC IS AN EQUAL OPPORTUNITY EMPLOYER
Job Tags
Hourly pay, Flexible hours,