Field Based Guia

Overview

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors.

Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. Will you join us Suvidanos to help achieve our Higher Purpose?

We are an empowered primary care, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve.

Our Culture & Core Beliefs

• Earn Trust
• Building Relationships
• Creating Joy
• Doing Right
• Improving Every Day
• Moving Forward

The Community Health Worker (Field-based) is focused on engaging patients who have struggled to establish a relationship with their healthcare provider at Suvida and/or who have recently been discharged from an acute care setting. The CHW will work alongside a multidisciplinary team to encourage patients to take an active role in their health by facilitating their engagement with Suvida, where they can access the tools necessary to make healthy lifestyle choices and adopt lifelong healthy behaviors.

This position will be primarily field-based and focused on conducting home visits to unengaged patients who (a) Suvida has been unable to establish a relationship with or (b) have recently been discharged from the acute care. This role will conduct described home visits alongside a trained Sales team member and will work closely with center-based teams throughout Houston in order to engage hard to reach patients and educate them on the value Suvida provides.

This is an excellent entry-level career opportunity for an ambitious, driven individual to make a meaningful impact on patients’ lives in a fast-paced, value-based care healthcare environment. Essential responsibilities consist of but not all inclusive:

• Conduct home visits to patients assigned to Suvida by their health plan to engage and educate them on the Suvida model. Help these patients schedule their first appointment at assigned location.
• Work collaboratively with patients, family, caregivers, healthcare providers, and external partners to engage and provide support to patients recently discharged from acute care.
• Partner with the clinical and case management team on transitions of care planning and referrals to post-acute providers.
• Promote a collaborative communication between all health care team members, internal multidisciplinary teams, inclusive patients/clients, families, and significant others to ensure the process of integrated care services are targeted, appropriate, and beneficial.
• Utilize knowledge of applicable laws, regulations, government, and insurance benefits as well as practice guidelines and standards of practice.
• Document all interventions in the patient medical record both timely and accurately including all elements of clinic visits, in home, telephonic engagement, or texting.
• Support departmental goals to contribute to the success of the organization.
• Serve as preceptor, mentor, and resource to less experienced staff.
• Maintain knowledge of Medicare, Medicaid, and other program benefits to assist patients.
• Other duties as assigned by Guia Manager.

• CHW certification
• Bachelor’s Degree preferred

• 4-5 years of experience working in healthcare setting or relevant experience.
• Expertise connecting patients and ensuring closed loop referral with community resources and governmental…