Job Description

A Community Wellness Advocate (CWA) is a trusted member of the community who helps high risk patients maintain stable health and wellness along a continuum, through integrating and connecting hospital, home-based, and community-based services. CWAs are responsible for providing advocacy and case management services; developing an interdisciplinary care plan based on identified patient needs; facilitating access to social service resources and other internal and external resources; monitoring the patient’s progress; and problem-solving with patients to both accelerate and enhance access to concrete supports. CWAs provide in-home or community-based one-on-one, family, and/or interdisciplinary group support to high risk care patients and collaborates with the Patient Care Manager, PCP, and other members of the care team to conduct needs assessments to identify and respond to barriers to the patient’s health and wellness. Essential duties include initiating face to face contact with eligible patients, scheduling and completing visits and follow-ups, teaching educational messages, participating in community outreach, working with patients and providers to set and achieve care goals, reinforcing disease self-management education, presenting patients at case review meetings, functioning within an interdisciplinary team, documenting patient progress in Epic system, assisting patients with records and appointments, helping with applications for assistance programs, providing advocacy and warm handoffs to programs, addressing barriers to care, coordinating with long-term services, providing outreach and accompaniment to medical appointments, establishing trusting relationships, participating in training and meetings, and developing community relationships. The CWA will not provide hands on care or home health services such as performance assessments, care provision, treatment, counseling, or health status monitoring. Requirements include HS Diploma with community experience or Bachelor’s degree, valid MA driver’s license and reliable transportation, minimum 2 years healthcare or community-based experience, basic healthcare system knowledge, outstanding interpersonal skills, interest in community health, organizational skills, English communication skills, fluency in Haitian Creole or Spanish preferred, understanding of cultural and socioeconomic health factors, proficiency with Microsoft Office and data entry. Boston Medical Center is an equal opportunity employer committed to health equity and employee support.

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