Case Management Coordinator

Job Summary

The Community Health Worker will support Wholecare members by conducting outreach, identifying health and social needs, and connecting members with appropriate healthcare and community resources. The position plays an important role in improving member health outcomes and access to care. Primary responsibilities include member outreach and education, coordination of healthcare and social-service resources, and assistance with barriers such as transportation, childcare, housing, and other social determinants of health.

Key Responsibilities

• Conduct face-to-face and telephone outreach to members regarding preventive health services, care gaps, maternity, care transitions, chronic conditions, and health-related social needs.
• Educate members on the importance of preventive healthcare and available benefits and services.
• Assess member needs and make appropriate referrals to healthcare providers, care management programs, and community resources.
• Establish supportive relationships with members, providers, community organizations, and human-service agencies.
• Connect members with resources such as WIC, Head Start programs, community centers, homeless shelters, and other social-service organizations.
• Conduct Social Determinants of Health (SDOH) assessments and assist members with addressing identified barriers.
• Assist members with scheduling healthcare appointments and accessing appropriate services.
• Provide information regarding healthcare benefits and available community resources.
• Document and communicate outreach activities, outcomes, referrals, and member needs to management and team members.
• Participate in the development of educational materials and programs designed to reach at-risk populations.
• Represent the organization at community events and activities sponsored by community partners.
• Collaborate with internal teams, healthcare providers, and community organizations to coordinate services.

Minimum Education & Experience Requirements

• High School Diploma or GED required.
• Minimum of 1 year of Community Health Worker experience or experience in a related field.
• Lived experience within the community served required.
• Experience working with Medicaid members or other at-risk populations preferred.
• Healthcare customer service or member services experience preferred.
• Experience working with community-based organizations and social-service resources preferred.

Special Requirements

• Must be bilingual in English and Spanish.
• Must obtain Certified Community Health Worker (CCHW) certification through the PA Certification Board within 12 months of start date.
• Must complete the required Housing Coordinator Glider assessment (Highmark-30231161) and provide the assessment link.
• Must be a U.S. Citizen.
• Must reside in Adams, Lancaster, Lebanon, or York County, Pennsylvania.
• Must have the ability to travel locally 50–75% of the time.

Knowledge, Skills, and Abilities

• Knowledge of community health, healthcare navigation, and social-service resources.
• Understanding of healthcare-related social needs and barriers, including transportation, childcare, housing, financial challenges, and access to preventive care.
• Knowledge of customer service principles and member needs assessment.
• Understanding of cultural competency and sensitivity when working with diverse populations and individuals with limited English proficiency.
• Strong verbal and written communication skills in English and Spanish.
• Strong interpersonal and relationship-building skills.
• Ability to demonstrate patience, empathy, and professionalism when working with members and community partners.
• Ability to work independently while also functioning effectively as part of a team.
• Strong problem-solving and critical-thinking skills.
• Ability to manage multiple priorities and respond to member needs promptly.
• Proactive, self-directed, creative, and assertive approach to problem-solving.
• Ability to maintain accurate documentation and communicate outreach results effectively.
• Ability to establish rapport and build trust with members, providers, and community organizations.
• Basic computer and electronic documentation skills.