Community Health Worker, Enhanced Care Management

Salary Range: $23.00-$24.88 per hour

Position Overview

The Office of Diversion and Reentry (ODR) within the Los Angeles County Department of Health Services is seeking a dedicated Community Health Worker (CHW) to serve as a case manager on the Enhanced Care Management (ECM) Team.

The ODR ECM program is intended to provide additional health and mental health resources, services and long-term support to individuals who are ODR clients.

Clients in the ODR ECM program are referred to by Health plans as well as ODR programs.  Services are coordinated by an ECM care team including the CHW who will work in collaboration with other clinical team members who work with the client as they transition from custody or who has been an ODR client but was referred for individualized case management, ensuring that their healthcare needs are met through enhanced services.

The Community Health Worker coordinates multifaceted needs of the client from physical health, mental health, and housing care in collaboration with the multidisciplinary team and often in collaboration with contracted intensive case management service (ICMS) providers.

Currently, ODR has a hybrid work schedule with a combination of workdays in the office, in the field and remote.

This may change at discretion of DHS.

ESSENTIAL FUNCTIONS

Case Management & Field-Based Engagement


* Receives referrals from care partners, ODR social workers, court team, and ECM program staff for enrollment into ECM case management services.


* Assist in identifying early signs of crisis and collaborate with providers and the ECM Coordinated Care Team to respond appropriately.


* Oversee provision of ECM services, creation, and implementation of the patient tailored Care Plan.


* Provide transportation support for clients during hospitalizations, evaluations, or other urgent care needs, following safety protocols and program guidelines.


* Conduct Assessments and collaborate on developing Care Plans for enrolled clients


* Coordinate Medical/Housing/Behavioral Health provider visits

Peer Support & Collaboration


* Serves as an advocate for client/patient access to healthcare and community resources and assists clients in obtaining and completing benefit services as needed.


* Offer emotional support, encouragement, and guidance to help clients engage with mental, physical and behavioral health treatment, housing services, and community resources.


* Assist clients in understanding and navigating their care plans, appointments, and expectations from service providers and ECM team.


* Provides emergency services to clients by making referrals to appropriate supportive agencies and arranging appointments and transportation.


* Takes medical, mental health, family, social history and assists clients in completing necessary forms.



* Facilitates client development of independent living skills and assisting with care plan goals and healthcare referrals and appointme...