Sr Social Determinants Coord - Harris Health System

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

JOB SUMMARY

The Sr. Social Determinants Coordinator supports all member facing departments in addressing the social needs of all membership, primarily STAR+PLUS. The Sr. Social Determinants Coordinator will support implementation of social determinants programs, including connecting referred members to community resources and working with community partners to improve overall health of members referred. The Sr. Social Determinants Coordinator is comfortable working with underserved populations and will be responsible for completing program administrative functions, data collection and reporting member outcomes.

JOB SPECIFICATIONS

• Track the social needs of members referred including status of need and how it is fulfilled. Contacts members and community programs to assess eligibility for programs and ensure needs are met.
• Review and analyze member data to evaluate programs, interventions, protocols, and metrics that support improved well-being. Documents all social needs referrals and outcomes in the appropriate databases following protocol, and form completion, in a timely manner.
• Research developments in the field of social needs in Harris County and other service areas of health plans. Coordinates the development of processes to deliver social determinants related programs for all Community Health Choice plans, primarily for STAR+PLUS.
• Support the establishment of partners to address the social determinants of health among membership and the community. Completes any in-person, and/or virtual trainings related to Community Health Choice Plans, social needs, and service coordination.
• Create annual evaluation reports which include social determinants of health landscape of membership for all health plans. In addition, the report should include, types of social need broken down by membership groups, how needs are met, timeliness of response, and number of closed loops.
• Participates in curriculum development of Service Coordination training and assist with trainings related to the social determinants of health.
• Actively contribute to achievement of departmental goals, as identified in the departments annual business plan, including specific departmental process improvement plans, and other duties as assigned.

QUALIFICATIONS: Required

• Education/Specialized Training/Licensure: High School Degree or GED required.
• Community Health Worker Certificate or 7 years of equivalent work experience, in lieu of certificate required.
• Work Experience (Years and Area): 5 years of experience as a community health worker, health care navigator, resource navigator or in social needs referrals.
• Some exposure to STAR+PLUS is preferred.
• Software Proficiencies: MS Office (Word, Excel, Outlook)

Other:

• Must be able to work with projects requiring attention to detail.
• Good organization, critical thinking, and critical listening skills.
• Ability to communicate with a diverse group of people.
• Ability to work independently and to follow instructions.
• Ability to travel throughout Harris County and surrounding counties.
• Ability to work hours outside of normal workday.

Job Family/Job Title Competencies

• Problem Analysis
• Attention to Detail
• Problem Analysis
• Flexibility