Great Rivers Hub Intervention Coordinator
Job Title: Intervention Coordinator, Great Rivers Pathways Community Hub (job description PDF)
Reports to: Director, Great Rivers Hub
Organization: Great Rivers United Way
BACKGROUND AND GENERAL DESCRIPTION
Great Rivers United Way is working in partnership across government, health, and nonprofit sectors to create a system of community care coordination that among several objectives will connect people in need with resources available and assure at-risk populations are connected to holistic supports to improve their health. The nationally standardized Pathways Community HUB model focuses on completing pathways for high-risk individuals to reduce their risk and improve their overall health. Great Rivers Hub is the local implementation of the Pathways Community HUB model.
Great Rivers Hub functions as an administrative center for a community and region-wide network of care coordination agencies throughout identified communities who connect health and social services resources to disadvantaged populations. This model screens families for risk factors and connects them to Community Care Coordinators (CCCs), such as Community Health Workers (CHWs), who work for a variety of nonprofits and serve as a link to existing community resources.
A part-time (approximately 20 hours per week) Hub Intervention Coordinator will be responsible for guiding the intervention strategies and standardized protocols for Great Rivers Hub as well as managing intervention implementation for Great Rivers Hub’s strategic growth. Specific focus includes relationship development within the community/region to facilitate identified interventions for improved care to clients.
Regional travel will be required for this position.
Develop and implement the Great Rivers Hub interventions and care protocols to provide efficient and effective care for identified populations. Drive intervention strategies collaboration with community agencies and engagement with local health care systems.
Intervention and Protocol Development and Implementation
- Develop and maintain relationships with identified partners within the Great Rivers Hub region in order to implement identified interventions with specific client populations
- Develop intervention strategies according to Pathways Community Hub model, payer and grant needs and population focus to be implemented in coordination with community partners and Great Rivers Hub CCCs/CHWs
- Establish relationships with agencies and organizations as needed to develop and implement intervention strategies that improve health and wellness of Great Rivers Hub clients; particular focus on interventions to improve chronic disease prevention, disease management, and improved health outcomes
- Communicate with identified providers to share quality metrics and support utilization of shared metrics to enhance client/patient care
- Provide reporting and updates, as requested by Hub Director and Hub Operations Manager, related to intervention strategy development and standardize protocol implementation within the Great Rivers Hub region
Great Rivers Hub Model Implementation and Support
- Be responsive to referrals to the Great Rivers Hub and make appropriate assignments to care coordination agencies based on the needs of those referrals and process identified in the Great Rivers Hub policies and procedure manual
- Ensure appropriate referrals are connected to CCAs within time identified in the Hub Policies and Procedures; track trends in referrals on an ongoing basis
- Provide, at least monthly, active client lists to referral partners and facilitate connection to assigned CCCs/CHWs
- Maintain positive relationships with Care Coordination Agencies (CCAs), referral partners and community agencies providing interventions for clients
- Ensure that CCCs are enrolling referrals in a timely manner or discharging according to the Hub’s Policies and Procedures
- Assisting CCCs/CHWs with connecting to referral sources and providers to share client/patient data to enhance care and improve health outcomes
- Assist Hub Operations Manager to ensure CCAs and CCCs are compliant with Hub Policies and Procedures, to include identified intervention strategies and standardized protocols for care; provide training and coaching on intervention strategies to CCCs/CHWs on an ongoing basis to ensure proper implementation
- Work with Hub staff and community partners to develop the role of CCCs/CHWs locally, regionally, and Statewide
- Participate in Community Health Worker taskforce and workforce development locally, regionally, and Statewide
- Conduct quality assurance/quality improvement activities as needed; monitor quality improvement recommendations and requirements
- Collaborate with the Hub Director and other Hub staff to identify community service gaps and needs as identified by Hub data collection
- Assist Hub Director as needed to include activities identified through grants and other payer streams related to intervention and protocol development
- Participate in Community Advisory Board and Community of Practice meetings for Great Rivers Hub
- Develop and maintain strong relationships with the social service agencies and local health systems
- Leverage relationships with clinical and community organizations to implement clinical-community linkages for improved health outcomes for clients/patients
- Maintain effective communication and relationships with key community partners in government, social services and healthcare
- Attend necessary meetings within the Great Rivers Hub region to support and maintain community partner relationships
Great Rivers United Way Responsibilities
- Develop and maintain a thorough and nuanced understanding of Great Rivers United Way programs and initiatives
- Represent all Great Rivers United Way partner agencies with integrity and respect
- Attend GRUW related events and provide needed updates as requested by GRUW staff, Executive Director and Board of Directors
- Other duties as assigned
Our ideal candidate would have a Bachelor’s degree in public health, nursing, biomedical, biology or related field.
Minimum of two years of progressively responsible experience in public health, healthcare, community engagement and healthcare technology. Experience with implementing clinical/community linkages.
Knowledge of prevention activities for overall health and wellness. Ideally demonstrate expertise related to diabetes, cardiovascular disease, mental health and social determinants of health.
Demonstrated ability to build and sustain productive relationships and work professionally and effectively with diverse individuals, groups, organizations and communities. Strong organizational and time management skills. Self-motivated and ability to work independently and within a team setting. Ability to work in a fast-paced, dynamic environment, handling multiple tasks simultaneously. Familiarity with health care services available in the region. Intermediate computer skills in Word, Excel, and PowerPoint.
- Regional travel will be required for this position
- Must be able to pass a background check and monthly exclusion checks
Application Deadline: March 15, 2019
Send letter of interest and resume to:
GRUW – Human Resources
1855 East Main Street
Onalaska, WI 54650
Or, email: firstname.lastname@example.org
Great Rivers United Way is an Equal Opportunity Employer.