AmeriCorps Wellness Care Coordinator

Job Description

Job Description

Summary :

Boston Health Care for the Homeless Program (BHCHP) serves individuals experiencing homelessness in the Greater Boston area. BHCHP recognizes that there is a correlation between mental health, homelessness, and chronic disease. To respond to the needs of our patients, BHCHP has formed a Wellness team of providers.  The AmeriCorps Wellness Care Coordinator will provide care coordination and health education to individuals served by our program with the goal of improving patients’ overall health and well-being. The AmeriCorps Wellness Care Coordinator will collaborate closely with the Behavioral Health Team and BHCHP chronic disease teams to support patients in navigating their healthcare needs.  This includes managing referrals, finding resources, assisting vulnerable patients in following through with external appointments, and more.  The Wellness Care Coordinator will visit various BHCHP sites to provide health education, information about connecting to Behavioral Health services, and to run wellness support groups. The Member will also serve as an individual support for patients who attend the weekly ( diabetes) wellness support group (that is hosted by the Behavioral Health team). The Wellness Care Coordinator will be responsible making notes in the electronic medical record when pertinent labs are due for upcoming appointments. The coordinator will provide necessary outreach / phone follow-up with patients closely connected to the team to ensure optimum care is delivered.

Additional duties include entering necessary information into the electronic medical record and maintaining close communication with clinic staff. In addition to these core responsibilities, the Member will fulfill marginal functions around patient education, managing volunteers, training, service projects, and data reporting.

Essential Functions :

• Serve as a point of connection for patients being discharged from the Barbara McInnis House to Behavioral Health outpatient services
• Liaison with the Hypertension team to promote seamless chronic disease management
• Follow through on referrals made to the wellness team
• Provide telephonic and in-person outreach to wellness team patients
• Monitor the A1C results of wellness support group patients
• Create and attend tabling events to provide chronic disease and wellness education
• Assist with and run A1C events
• Assist with and run support and activity groups for patients throughout the program
• Make notes in the electronic medical records when an A1C is due for a scheduled appointment
• Provide support and patient navigation for patients attending the wellness group
• Assist vulnerable patients with external appointments (coordinating with and supporting patients to set them up for success with external appointments, with the ultimate goal of self-sufficiency)
• Maintain all clients' privacy and confidentiality, adhering to HIPAA regulations and those policies as implemented by the BHCHP
• Update timekeeping system and Epic regularly to document hours and patient encounters respectively
• Work with BH Equity team on patient chart reviews and making appropriate PPTs as needed
• Help to create organized resources for chronic disease management specific to our patient population – and update and manage upkeep of all these resources on the CDM Team webpage on the BHCHP wiki so all information is available at one location

Marginal Functions :

Qualifications :

Commitment requirements :

It is anticipated that the 2025-2026 year of service will begin September 8, 2025 and run through July, 24 2026.The time requirement for this position is a minimum 40 hours / week; 1,700 hours required by the end of the term of service, with a focus on in person work. The Member must serve for the length of program and meet the minimum hours served requirement to successfully complete their service year. Exact service hours will depend on the service location and assigned projects. Anticipated schedule of Monday – Friday 8 : 30 am – 5 : 00 pm, with occasional 11 : 00am – 7 : 00pm shifts, and rotating Saturdays.

Benefits :

For a 10 month full-time commitment and minimum of 1,700 hours of AmeriCorps service, members may be eligible to receive :

BHCHP is committed to providing equal opportunities. We serve and partner with various organizations, and are dedicated to non-discrimination. It is our policy to ensure that all individuals with whom we are in contact are treated without regard to age, color, disability, gender, marital status, national origin, religion, sexual orientation or expression, or veteran status. BHCHP welcomes applications from individuals with disabilities and will make reasonable accommodations for interviews and for service upon request.

Does this amazing opportunity interest you? Then we'd love to hear from you.

As an equal opportunity employer, Boston Health Care for the Homeless Program is committed to providing employment opportunities to all qualified individuals and does not discriminate on the basis of race, color, ethnicity, religion, sex, gender, gender identity and expression, sexual orientation, national origin, disability, age, marital status, veteran status, pregnancy, parental status, genetic information or characteristics, or any other basis prohibited by applicable law.

Covid-19 Vaccination : Proof of Covid-19 vaccination(s) is optional for employment. Candidates who are offered employment will be given details about how to demonstrate receipt of vaccination if they choose to.

Please Note : Employment at Boston Health Care for the Homeless is at-will. Boston Health Care for the Homeless does not sponsor work authorization visas.

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