Good Neighbor Community Health Center (Columbus) and GN Fremont are primary health care clinics that offer a wide variety of services, including family and general practice medicine, pediatrics, OB/GYN care, dentistry and behavioral health. We are located together to better serve our patients, offering them a "one-stop shop" for their healthcare needs. Good Neighbor Community Health Center and Good Neighbor Fremont are both federally qualified community health centers (FQHC). FQHC is a federal designation given by the Bureau of Primary Health Care at the federal Department of Health and Human Services. FQHCs are located in, or serve, a federally designated medically underserved area/population. In 2020, Good Neighbor Community Health Centers cared for 10,978 patients from more than 45 zip codes.
Good Neighbor Community Health Center and Good Neighbor Fremont employ a variety of clinicians, nurses and other staff to provide high-quality, patient-centered care to under-served individuals and families in our cross-cultural, primary care settings. Bilingual language skills (English/Spanish) are a plus.
In addition to a competitive salary, employees who work a minimum of 30 hours a week are eligible for benefits. Coverage begins on the first of the month after their hire date.
Our current job openings are listed below. You can also find a summary of benefits, and access our easy Application for Employment.
Help make a difference in the life and health of your community! Come join our team!
We are a qualifying employer for the federal Public Service Loan Forgiveness program. Learn more here.
Chronic Disease Case Worker
ESSENTIAL JOB FUNCTIONS
- Coordinates patient care through ongoing collaboration with PCP, patient/family, community, and other members of the health care team. Fosters a team approach and includes patient/family as active members of the team. Takes the lead in ensuring the continuity of care which extends beyond the practice boundaries. Serves as liaison to acute care hospitals, specialists, and post-acute care services.
- Provides patient self-management support with a focus on empowering the patient/family to build capacity for self- care.
- Systematically monitor patient progress and treatment plans, report changes of symptoms, side effects or complications.
- Provides follow-up with patient/family when patient transitions from one setting to another. Completes timely post-hospital follow-up: Medication reconciliation, PCP or specialist follow-up appointment, assess symptoms, teach warning signs, review discharge instructions, coordination of care, and problem solve barriers.
- Maintains required documentation for all care management activities via the use of a web-based data entry system.
- Works with practice to continuously evaluate process, identify problems, and propose/develop process improvement strategies to enhance care management and Patient Centered Medical Home delivery of care model.
- Perform all other duties as assigned.
Certified Medical Assistant /Certified Nurse’s Assistant/Licenses Practical Nursing Degree/Dietician/Social Services or something similar
- Critical thinking skills and ability to analyze complex data sets.
- Ability to communicate effectively and articulate both orally and in writing.
- Proficient with Microsoft Office Suite or related software.
- Ability to work well with individuals of diverse socioeconomic, cultural, and intellectual backgrounds.
- Knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, health risk assessment, and patient education.
- 2-3 yeas of previous experience in social services or related fields.
- Bi-lingual preferred.