Mental Health Community Health Worker

Job Description

Job Description

COMMUNITY HEALTH WORKER

JOB DESCRIPTION

DEPARTMENT: Outreach

REPORTS TO: Mental Health Department Manager/Office Manager

PRIMARY DUTIES/RESPONSIBILITIES:

The Mental Health Community Health Worker serves as a trusted bridge between patients, the behavioral health and primary care teams, and community resources. The MHCHW provides culturally responsive, patient-centered, trauma-informed outreach, education, advocacy, practical support, and follow-up to improve access, engagement, and continuity of care.

The MHCHW helps patients identify goals and barriers, understand available services, strengthen self-management and coping skills, and connect with needed healthcare and social supports. This is a non-clinical role. The MHCHW does not diagnose, provide counseling or medical advice, make independent clinical decisions, or perform duties outside approved training and scope.

Essential Functions

1. Relationship-Based Patient Support and Education

• Establish trusting, respectful relationships with patients and provide consistent, nonjudgmental support using trauma-informed and culturally responsive practices.
• Help patients identify personal goals, barriers, strengths, and practical next steps toward improved mental health and overall wellness.
• Provide approved, non-clinical education regarding mental health, wellness, coping, self-management, available services, and stigma reduction using clear, plain language.
• Review and respond to assigned patient messages and telephone calls within the position's scope; recognize concerns requiring prompt escalation to licensed clinical staff or established crisis resources.

2. Resource Navigation and Referral Follow-Up

• Identify non-clinical barriers involving housing, food, transportation, employment, finances, insurance, social support, safety, technology, or access to healthcare and behavioral health services.
• Connect patients with approved community resources and refer patients to Navigator Services for insurance information and enrollment assistance.
• Follow up on referrals and missed or overdue appointments, help patients address access barriers, and identify alternative resources when the original connection is unsuccessful.
• Maintain an accurate Mental Health Department resource directory and current working relationships with community agencies, schools, hospitals, healthcare providers, and other partners.

3. Outreach, Advocacy, and Community Engagement

• Conduct assigned telephone, approved electronic, in-person, and community outreach; document contacts, attempts, referrals, barriers, and outcomes within required timeframes.
• Participate in approved health fairs, organizational events, mental health awareness activities, school or community partnerships, and presentations using approved information and materials.
• Help patients understand available services, prepare questions, communicate concerns, and participate in care while respecting patient choice and self-determination.
• Develop and sustain community relationships that expand access to reliable mental health information and resources; provide or assist with approved mental health education for SICHC employees.

4. Team Collaboration, Documentation, and Improvement

• Coordinate closely with the Mental Health Department Manager, Mental Health Director, licensed clinical staff, primary care teams, Navigators, and community partners.
• Complete routine correspondence, forms, record requests, outreach tracking, and other approved non-clinical mental health documentation accurately and on time.
• Support data collection and quality measures related to patient access, engagement, referral completion, and follow-up; participate in meetings, training, quality initiatives, and departmental activities.
• Immediately escalate emergencies, potential harm to self or others, abuse or neglect, safety threats, significant clinical concerns, or any issue outside the MHCHW role according to SICHC procedures

Minimum Qualifications

Education: High school diploma or GED required. Completion of an approved Community Health Worker certification program within six months of hire is required; the employee must maintain all required certification.

Experience: One to two years of experience in behavioral health, healthcare, social services, community health, patient navigation, care coordination, case management, or a related field preferred. Experience serving underserved or vulnerable populations is strongly preferred.

Preferred Background: Experience in an FQHC, community health center, integrated healthcare, primary care, or behavioral health setting; experience with an EHR or care-management system; motivational interviewing or other patient-engagement techniques; peer-support or case-management experience; and knowledge of local resources.

Language: Bilingual or multilingual skills appropriate to the patient population are preferred.

Knowledge, Skills, and Abilities

• Strong verbal, written, interpersonal, and active-listening skills with the ability to build trust and rapport across diverse patient populations.
• Understanding of common mental health concerns, barriers to care, trauma-informed practice, stigma reduction, professional boundaries, and the limits of a non-clinical scope.
• Ability to recognize concerns requiring escalation; connect patients with crisis, healthcare, and social-service resources; and follow established safety and communication procedures.
• Strong organization, documentation, prioritization, follow-up, problem-solving, teamwork, reliability, and time-management skills; ability to work independently and within an interdisciplinary team.
• Computer proficiency and ability to use an electronic health record, secure communication tools, Microsoft Office, and common office technology while protecting confidentiality.

Key Performance Expectations

• Engage assigned patients respectfully and maintain timely, consistent outreach and follow-up.
• Support successful connections to behavioral health, healthcare, insurance-navigation, and community resources and identify alternatives when barriers arise.
• Document contacts, referrals, outreach attempts, barriers, outcomes, and quality-measure activity accurately and within required timeframes.
• Demonstrate appropriate escalation, confidentiality, trauma-informed communication, ethical conduct, and professional boundaries.
• Maintain current resource information and contribute effectively to department, outreach, training, and quality-improvement activities.

Role Boundaries

The MHCHW provides non-clinical education, outreach, advocacy, practical support, resource navigation, and referral follow-up. The MHCHW does not diagnose, assess clinical risk independently, provide therapy or counseling, recommend treatment, or replace licensed clinical judgment. Clinical, crisis, safety, and scope concerns must be escalated immediately through established procedures.

Physical Demands / Work Environment

Work may occur in office, clinical, community, outdoor outreach, and approved virtual settings. The employee must regularly communicate in person and by telephone, use a computer, sit, stand, walk, and travel between SICHC locations and community sites. Reliable transportation and a valid driver's license are required. Occasional evening or weekend outreach may be necessary. The position may include an approved hybrid work model. Reasonable accommodations will be considered in accordance with applicable law.

Confidentiality and Compliance

The employee must comply with HIPAA, privacy, information-security, patient-safety, mandatory-reporting, crisis-escalation, documentation, employee-conduct, professional-boundary, and applicable CHW certification requirements.

Disclaimer

This description summarizes the general nature and level of work and is not an exhaustive list. Duties may change based on organizational needs, funding, law, and policy. Southern Indiana Community Health Care provides equal employment opportunity, does not discriminate based on legally protected status, and provides reasonable accommodations for qualified individuals with disabilities.

The State of Indiana was awarded funding therefore have listed the below State Disclosure and candidates may ask further questions during interview process".

Disclosure:

This Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $206,927,896.80 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.