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### Job Duties

Position Summary: The Community Health Worker (CHW) at BTH is a trusted frontline public health worker who provides individualized support, care coordination, and advocacy for guests receiving medical respite/recuperative care services. This position works with guests experiencing homelessness, recent hospitalization, complex medical needs, mental health challenges, and barriers to accessing traditional care. The CHW collaborates closely with clinical providers, house managers, and external agencies to promote recovery, reduce avoidable hospital utilization, and support safe transitions back to the community.

Essential Duties & Responsibilities

Guest Support & Engagement:

Build rapport and trust with guests using trauma-informed, culturally responsive, and harm-reduction principles.

Conduct guest intake assessments, including social needs, health literacy, barriers to care, and readiness for follow-up services.

Assist guests in understanding and following care plans, medication schedules, and provider instructions.

Provide daily check-ins, goal-setting support, and motivational interviewing to encourage engagement in care.

Care Coordination & Navigation:

Coordinate follow-up medical appointments, specialty visits, diagnostic testing, and transportation.

Assist guests with enrolling in or navigating Medicaid/MHCP or managed care plans as applicable.

Facilitate communication between guests and medical providers, ensuring timely access to needed services.

Support discharge planning by assisting with referrals to housing programs, behavioral health services, substance-use treatment, and community resources.

Health Education & Coaching:

Provide health education on topics such as chronic disease management, medication adherence, harm reduction, and preventive care.

Assist guests in understanding their health conditions and how to advocate for themselves within the healthcare system.

Support guests in building self-management skills to improve long-term health outcomes.

Documentation & Compliance:

Maintain accurate, timely, and HIPAA-compliant documentation in the electronic health record (EHR).

Track service delivery metrics, care plans, and guest goals according to MHCP and organizational requirements.

Participate in case conferences, interdisciplinary team meetings, and quality improvement initiatives.

Advocacy & Resource Navigation:

Connect guests with community-based organizations for food access, ID/document recovery, benefits assistance, workforce programs, and housing.

Advocate for guests’ rights and needs across health and social service systems.

Assist guests in applying for benefits such as SNAP, SSI/SSDI, veteran benefits, and local supportive programs.

Program & Team Support:

Collaborate with medical team, house managers, social workers, and external or internal behavioral health providers to support holistic guest care.

Provide crisis prevention and de-escalation support following program policies.

Participate in staff trainings, program development, policy, process and procedure development and community outreach.

Support guests by helping them get oriented and accustomed to the home.

Receive BTH guest referrals and connect with the appropriate contact for admission screening.

Help to keep the house stocked with food to ensure food security.

Afternoon / evening shifts, preparing nightly family-style dinner and sharing the meal with guests.

Uphold facility standards related to safety, infection control, boundaries, and guest rights.

Keep the house clean, safe and in good repair and help guests understand that expectation as well.

Maintain relationships and extend welcome to former guests as appropriate, including receiving mail, inviting them to visit the house, etc.

Collaborates with BTH team members to create a positive and healthy work environment.

Supports the creation of systems and development opportunities.

Engage in professional development in order to meet certification requirements and ensure culturally responsive best practices are applied.

Other duties as assigned within the scope of practice and to maintain and grow BTH.

Work Environment & Physical Requirements:

Work performed in a medical respite/recuperative care setting, with occasional community-based outreach.

Ability to lift up to 25 lbs. occasionally and perform short periods of walking, standing, and climbing stairs.

Exposure to individuals in crisis, non-traditional schedules, and high-stress situations.

Must follow all infection-control, PPE, and safety protocols.

Ability to sit and use the computer for extended lengths of time.

Preferred Core Competencies or have a willingness to be trained

Trauma-Informed Care

Motivational Interviewing

Harm Reduction

Cultural Humility

Crisis De-escalation

Health Systems Navigation

Collaboration & Teamwork

Guest/Client Advocacy

Documentation Accuracy

### Minimum Education Required

High school diploma or equivalent required

CHW Certification (state-recognized) required

Lived experience relevant to the BTH guest population (e.g., homelessness, recovery, reentry) encouraged and valued but not required.

Knowledge of community resources is a plus but not required

Strong communication, problem solving, and interpersonal skills

Ability to work effectively with individuals facing medical, behavioral health, and socioeconomic challenges

Current CPR/First Aid certification and overdose prevention training or willingness to obtain (paid for by BTH) within the first month of employment at BTH

### Minimum Experience Required

0

### Shift

Other

### Number of Openings

2

### Public Transportation Accessible

Yes

### Veterans Encouraged to Apply

Yes

### Physical Required

Yes

### Drug Test Required

No

### Compensation

$19.00 - $24.00 / Hourly

### Postal Code

55806

### Place of Work

On-site

### Requisition ID

3698

### Job Type

Part Time

### Job Benefits

Join our amazing team and where your work will matter. Since 2018, BTH has been offering hospitality to people experiencing homelessness who’ve had an acute medical condition and are ready to leave the hospital, but need a safe place to continue to heal. BTH serves individuals in Duluth, MN and the surrounding region. While guests stay with us, we work on supporting social determinants of health, housing and connections to supports in the community in hopes that they'll be in a better position when they leave our home.

### Application Email

[email protected]