Job Requirements Located in Largo in the heart of Prince George’s County, our new state-of-the-art regional medical center (University of Maryland Capital Region Medical Center) will provide improved access to primary and ambulatory care services and serve as a tertiary care center for critically ill patients. In addition, our new space will allow us to expand our offerings as a community partner to help improve the health status of Prince George’s County residents.
We are seeking a compassionate individual to provide disease management, disease prevention and social services to high-risk patients who have an elevated risk of readmission. In this role, the CHW will perform an in-depth assessment of the patients, in order to determine the care they need and connect them to the appropriate services. This candidate will report to the Manager of Care Transitions and will work normal business hours.
The primary areas in the hospital will be the admitted border patients housed in the Emergency Room and the Observation unit. Principal Duties: 1. Assesses patients that are at high risk for health status decline or readmission to determine their medical and social needs. 2.
Follows the patient through their hospital stay to monitor for changes and contact the patient/family within 72 hours post discharge. 3. Ensures that the patient has a Primary Care Provider (PCP) appointment scheduled prior to discharge if the patient agrees. 4. Collaborates and communicates with Case Managers to ensure a safe discharge. 5.
Provides resources that support any identified social disparities of health. 6. Interprets and discusses information on the After-visit summary (AVS) to ensure the patient understands discharge instructions, medications and the importance of follow up care. 7. Assists with scheduling PCP or Specialists as needed. 8.
Performs data entry in Smartsheet and enter thorough progress notes in EPIC. 9. Collaborates with the interdisciplinary team to meet the patient’s needs. Work Experience
High School Diploma or GED Required Certification: Current Maryland Certification in good standing as a Community Health Worker (CHW). Must possess: 1-3 years of direct Community Health Worker experience required 1-3 years of care coordination experience is required/ 5+ preferred Proficiency in Computer Systems; Microsoft Office Suite (Basic, Excel) Basic knowledge and working experience with Medical Terminology required Benefits All your information will be kept confidential according to EEO guidelines.
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$19.50-$27.31 Review the 2025-2026 UMMS Benefits Guide