Senior Community Wellness Advocate

POSITION SUMMARY:

The Community Wellness Advocate (CWA) at the Neurodiverse Urban Youth (NUY) Center plays a vital role in overseeing the administrative and operational aspects of a multi-disciplinary team of pediatric specialists. In collaboration with clinical pediatric specialists from Boston Medical Center's Developmental and Behavioral Pediatrics (DBP), Pediatric Neurology, and Pediatric Psychiatry, the CWA ensures comprehensive care coordination for NUY Center patients, partnering with families to establish and enact health goals; facilitating access to and coordination among services and resources- internal and external. The CWA is responsible for managing incoming referrals, developing educational programs, monitoring quality improvement, and tracking interdisciplinary care plans based on individual patient needs. The CWA will provide advocacy and case management services through clinic-based, in-home, or community-based one-on-one, family, and interdisciplinary group support. As a member of an innovative care team, the CWA helps identify and address barriers to health and wellness and contributes to the testing of new care delivery models. The role requires flexibility, as responsibilities may evolve with the NUY model.

Position: Senior Community Wellness Advocate

Department: Development Behavioral Pediatrics

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Referral Responsibilities:

• Triaging the referral work queues for DBP, Pedi Neuro and Pedi Psych by reviewing medical charts and discussing clinical concerns with referring clinicians to identify appropriate patients for the NUY Center and redirect the referrals from the individual specialty to the NUY Center;
• Ensuring thorough and high quality referrals are received by identifying additional paperwork needed and recommending additional/alternative referrals/services for families whilst waiting to be evaluated at the NUY Center;
• Conducting initial calls with families to gather background information;
• Fielding administrative/operational requests from clinicians and staff regarding referrals;
• Collaboratively developing policies and protocols for the administrative and operational functions of the NUY Center. Design tasks may include the creation/revision of NUY Center guidelines and policy, the development of effective protocols, and the implementation of workflows to support collaboration with internal programs/departments and external stakeholders;
• Establishing partnerships with referring health care centers to develop effective referral pathways and communication strategies to promote high quality referrals, improve access to developmental and behavioral health treatment and services for referred patients and promote patient wrap around care;
• Providing targeted education to health care centers on screening tools, transition to adulthood services/supports and referral processes;
• Creating resources and tools for health care center utilization, to streamline the referral process. Creating resources for families on services/supports to access whilst waiting for an appointment in the NUY Center and outline details of what will happen when seen in the NUY Center to prepare families for their appointment.

Clinical Care Coordination Responsibilities:

• Provision of excellent patient and clinician service skills;
• Supporting adolescents, families, and clinicians during patient appointments and providing ongoing support between appointments;
• Providing direct support to families who are navigating a neurodiverse diagnosis, through provision of individualized and tailored resources, referrals to community-based programs, and consistent and ongoing follow-up care. Areas of support may encompass special education transition services in high school, outpatient therapeutic services, activities of daily living, caregiver and sibling supports, state and federal benefits, state agencies, independent living skills, decision-making supports and vocational training;
• Utilizing exceptional problem solving skills to assist families in overcoming barriers related to the patient's service needs, and trouble-shooting challenges that may arise. Discussing resources/supports with families by meeting them where they are at, being empathetic to their concerns and addressing all questions;
• Documenting patient communications in the electronic medical record in a timely and comprehensive manner;
• Cultivating and maintaining relationships with key stakeholders serving neurodiverse adolescents, including state and clinical agencies, community-based programs and school systems in order to review services and act as a liaison between the agency, family and clinicians;
• Participating in the case review of complex neurodiverse patients with the interdisciplinary care team to provide a comprehensive approach to care for the patients and their families;
• Providing excellent communication with health care clinicians, ancillary support staff and related service professionals to see that care needs are coordinated and addressed in a timely manner;
• Supporting the clinicians in strategic planning including recommending and developing changes for new clinical or educational services as needed.

Educational Programming Development

• Designing and refining resources and educational programming to support neurodiverse adolescents and their families in collaboration with the clinicians;
• Developing a resource library for patients and families to access that covers topics related to services/supports for neurodiverse adolescents in the transition to adulthood. Resources may include informational sheets, guides, workbooks, visuals and social stories, helpful websites, and recorded webinars;
• Designing and implementing parent/caregiver trainings and information sessions on transition to adulthood and adult disability services topics;
• Offering drop-in hours for individualized support/education on navigating services/resources;
• Participating in curriculum development for internal/external staff on topics related to supporting neuordiverse adolescents such as transition services in high school, independent living and life skills, and identifying appropriate decision making support options. Delivering trainings, educational opportunities and consultation on the previously listed services/supports;
• Collaborating with internal BMC departments to develop programming/services for neurodiverse patients to access.

Quality Improvement

• Maximizing efficiency of operational systems with regards to the referrals by:
  
  
  • Evaluating efficiency of the referral workflow developed for key stakeholders to streamline the referral process;
  • Collaboratively identifying, implementing, and evaluating strategies to prevent erroneous/inappropriate referrals and improve referral quality;
  • Identifying opportunities for intra/interdepartmental operational process improvement;
  • Evaluating stakeholder satisfaction with the referral process, specifically the satisfaction of patients, families and referring clinicians;
  
  
  
  
• Monitoring and revising established referral operations to ensure that the workflows are developed, implemented, and evaluated as indicated.
• In collaboration with the interdisciplinary team, evaluating the clinical care by analyzing systems and trends to identify strengths and challenges, and implementing strategies for improvement of clinical outcomes;

OTHER DUTIES:

• Conforms to hospital standards of performance and conduct, including those pertaining to patient rights to ensure that exceptional customer service and patient care may be provided.
• Utilizes hospital's behavioral standards and RESPECT attributes as the basis for decision making and to support the hospital's mission and goals.
• Follows established hospital safety procedures.
• Executing tasks and duties as determined and assigned by supervisors.
• Perform other duties as needed- including working across a larger pool of CWAs in the ambulatory clinic setting for clinic integration and cross coverage support.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

Requires at a minimum a Master's degree in public health, child development or social work (or equivalent combination of formal education and experience).

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

MA Driver's License preferred.

EXPERIENCE:

At 2-5 years of clinical experience working in a pediatric setting, with 2 years of experience in program development/operational management of clinical programming focused on neurodiverse adolescents within a hospital or community health setting.

Equal Opportunity Employer/Disabled/Veterans