ICL Outreach Worker in Brooklyn, New York


Under the general direction of the Outreach Coordinator and Outreach Supervisor theOutreach Workerconducts outreach to locate, engage and attempt to enroll eligible clients into the Health Home. Ensures efficient and successful access and linkage to the full array of necessary physical and behavioral health services. Coordinates effective communication between all team members to the ultimate benefit of the patient.An Outreach Worker conducts interviews, intakes and screenings of clients to discern needs and makes referrals to appropriate agencies or contact persons, facilitating access to quality health care and social services, providing health education, bringing linguistically and culturally responsive health care directly to the community, helping people become equal partners in their health care, and increasing the community’s awareness of the presence of underserved populations. They disseminate information on available programs and services, and perform various administrative duties. They assist supervisory staff and visit clients in their homes to assess their needs or identify potential problems. They also serve as advocates for clients and help to bring about desired or necessary corrective action, or will assist in locating necessary help from their community to ensure that a service is provided. They also will assist clients and their families in crisis situations, and make necessary referrals. The Outreach Worker is responsible for the initial outreach and engagement of clients referred to the Health Home program. The successful Outreach Specialist will work with Care Coordinators to achieve a high rate of successful engagement.

  • Provide comprehensive education to potential Health Home members that highlights the benefits and promotes participation in care coordination service

  • Responsible for establishing relationships that are necessary for the continued engagement and care coordination services

  • Responsible for managing an assignment list of approximately 200 potential Health Home members over a 90 day period

  • Responsible for having potential members to sign a consent form expressing that they are willing to accept Health Home services and documenting their efforts in the selected Electronic Health Record software (EHR)

  • Responsible for Transferring the signed consent form for care coordination services, to their supervisory staff

  • Responsible for providing progressing diligent search efforts that includes mailing letters, making phone calls, texts, community/home visits, etc.

  • Responsible for discharging the potential members in EHR after 90days if they are unable to be located via diligent search or if they refuse the Health Home service.

  • Responsible for maintaining a tracking spreadsheet that will detail the steps taken during progressive diligent outreach and their outcomes for each member on their assignment list.

  • Responsible for engaging community referrals (ground ups) to educate them on the benefits of care coordination services and have them sign consent forms for service.

  • Conduct field, phone and mail outreach to individuals referred to ICL health homes.

  • Screen all referrals for additional ICL program participation.

  • Complete participant enrollments.

  • Track the outreach and engagement of all Lead Health Home referrals as required.

  • Gather, review, and file medical, mental health & substance use reports from respective providers as needed.

  • Outreach via phone, letter, and home visit clients who have active Medicaid.

  • Assist client with non-active Medicaid through initial entitlement process and internal referral.

  • Achieve an conversion rate comparable to or above industry standard

  • Participate in advocacy and direct action to end the twin crisis of AIDS and homelessness.

  • Conduct assigned administrative duties (mail, follow-up etc.) and other assigned job duties.

  • And other duties as may be assigned


Minimum:*Educational Requirements:*

Bachelor’s Degree or Master’s Degree in one of the following fields preferred: Social Work, Psychology, Education, Rehabilitation, Occupational Therapy, Counseling, Community Mental Health, Sociology, Speech and Hearing, Physical or Recreational therapy. Degrees in other related areas may be considered.

Minimum Experience Required:

For B.A. level candidates, two (2) years of related human services experience required in providing direct services to mentally disabled clients in order to link them to a broad range of services essential to successfully living in the community.

  • For M.A. level candidates, one (1) year of above human services experience.

Required Knowledge Skills and Abilities:

  • Working knowledge of computer software and electronic health record systems.
  • Demonstrated competency in written, verbal, and computational skills to present and document records in accordance with program standards.
  • Experienced in and demonstrated comprehensive understanding and working knowledge of the interdisciplinary planning process and the developmental treatment model.
  • Excellent interpersonal skills required.
  • You must have the ability and willingness to regularly travel, in some instances with clients in Agency vehicles, to many locations using various modes of reliable and safe transportation

  • * Preferred:* Knowledge of Medicaid, Social Security and other entitlements preferred.

Licensure: Valid driver’s license may be required, as determined by operational needs.

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Position Number: HH533618

Department: Pathway to Wellness

Job Locations: US-NY-Brooklyn

Type: Regular Full-Time

FLSA Status: Non-Exempt

Minimum Salary: USD $40,000.00/Yr.

Maximum Salary: USD $40,000.00/Yr.