Since 1985, Albuquerque Health Care for the Homeless has dedicated its mission exclusively to providing services to people experiencing homelessness. AHCH provides a distinctive continuum of integrated care through outreach and site-based services to address the health-related causes and consequences of homelessness. Our vision is to live in a world that is just and without homelessness. We believe that homelessness is an issue that can be solved through access to quality health care, adequate and affordable housing, and a living wage. We are looking for an engaged and dynamic candidate to join our Community Health Worker team in helping clients navigate care systems, while promoting health education, disease prevention, and wellness self-management. Community Health Workers assist clients on campus and in outreach settings, helping them to access public benefits, obtain identity documents, and apply for permanent and transitional housing programs. In consultation with clinical providers, Community Health Workers facilitate short-term care coordination and linkage to long-term care services for clients with complex health conditions. Utilizing community-based tools and methods, they assess needs, identify resources, and advocate for systems change with community stakeholders. The perfect candidate would have a deep understanding of the population we serve, a passion for individual and community advocacy, experience working with interdisciplinary care teams, and be a highly skilled communicator who will develop quick rapport with our clients. Duties and Responsibilities: * Clearly communicate with patients about their role in the patient’s care plan and the services available through them * Documents all encounters and contacts made on behalf of patients, including service plans and outcomes achieved by patients, into EHR within 72 hours * Completes and submits monthly reports; maintains comprehensive notes, release of information, assessments and other documents acquired on behalf of the client * Actively refer unengaged patients to Harm Reduction, Dental, Behavioral Health, and Case Management programs within AHCH * Assist patients in identifying socio-economic issues that affect their overall health and develop health/social management plans and goals * Communicate with benefit carriers about interventions provided to their members seeking services at the AHCH * Provide referrals and follow up services (care coordination) * Connect patients to community resources, including but not limited to locating, housing, food, clothing, education, life skills classes, and employment * Assist patients with finding community resources, scheduling appointments with social services agencies, and completing applications for benefits /programs for which they may be eligible, including Medicaid * Encourage and support patients to be active and engaged participants in their health and overall wellbeing * Works collaboratively and effectively within a team (medical/social services) and establishes positive, supportive relationships with staff and providers * Keep up to date on community resources * Must comply with all AHCH policies and procedures Minimum Qualifications: * Experience in social services, behavioral health or health care setting * Ability to complete NM Community Health Worker Certification within 90 days (training provided) * Experience working with complicated and co-occurring medical issues * Valid NM driving license with clean driving record * Ability to work with large, multi-disciplinary teams * High school diploma or equivalent  Preferred Qualifications:  * Previous work with an EMR * Associate degree in Human Services or relevant field * 1 year experience as CHW or Patient Care Coordinator * Experience with underserved, vulnerable populations * Bilingual Spanish/English * Experience working with those with mental illness or substance use disorder * Knowledge and understanding of harm reduction philosophy   All benefits start the month after you begin work: * Low cost medical, vision, and dental insurance with health club membership * Life insurance and Accidental Death and Dismemberment fully paid for by company * Long Term Disability fully paid for by company * Paid Time Off - 24 days in first year of employment * Catastrophic Sick Time accrual * 7 Paid holidays * Health Care and Dependent Care Flexible Spending Accounts * 401k with employer match * Student loan forgiveness eligible  We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. This organization participates in E-Verify.