Community Health Worker - Syracuse Community Health
Company: Forward Leading IPA
Location: Syracuse
Posted on: February 12, 2026
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Job Description:
Job Description Job Description Salary: $18.27-$28.85 Job Title:
Syracuse Community Health - Community Health Worker Reports to:
FLIPA Community Health Worker Supervisor and Syracuse Community
Health -Director of Quality. This position is an in-person role &
located at 930 S. Salina Street Syracuse, NY 13202. Social Care
Network Summary: The New York State Department of Health has
established Social Care Networks (SCNs) as part of the 1115 Waiver
Demonstration Amendment, The SCNs aim is to enhance the delivery of
social care services to Medicaid members by coordinating efforts
among community-based organizations (CBOs) and other health care
partners to create a more resilient, flexible, and accessible
social care system that reduces health disparities and advances
health equity. The SCN will collaborate with CBOs and other health
care partners, leveraging shared data and technology to coordinate
social care services for Medicaid members to improve access, ensure
reliable and timely referrals, streamline and track navigation and
completed referrals in closed loop systems and enhance
collaboration between social care service providers and other
regional partners. Job Summary: This position is responsible for
establishing trusting relationships with patients while providing
support in navigating and accessing resources and engaging patients
in goal-driven care. The Community Health Worker systematically
identifies, assesses, refers, and monitors high-need individuals to
ensure access to essential services while supporting providers and
the Care Team through an integrated approach to care management and
community outreach. This position is funded through March 2027.
Organizational Overview: Forward Leading IPA (FLIPA) is a nonprofit
membership association of safety net providers working in
partnership to provide the highest quality integrated healthcare to
historically underserved populations in Upstate New York since
2017. FLIPA is renowned for its commitment to integrating primary
care, behavioral health, and social care needs. Our growing
membership serves individuals across Upstate NY and includes
federally qualified health centers (FQHCs), behavioral health
providers, and a rural health network consisting of eight county
public health departments. Equal Employment Opportunity Statement:
At Forward Leading IPA (FLIPA), we deeply value diversity in
background, experience, and thought. We are committed to creating
an environment of belonging where all qualified applicants are
encouraged to apply and will receive equal consideration for
employment. Duties/Responsibilities: Provide a vital link between
local communities and healthcare provider by helping individuals
access resources and navigate systems. Proactively outreach and
engage identified individuals in need of services, follow up or
social care screening by connecting via phone calls, home visits
and/or in-person visits to other settings where patients can be
found. Support deployment of NYS Social Care Network screening and
referral process o Engage directly with Medicaid individuals to
administer the Health-Related Social Needs Screening Tool to
identify needed areas of support. o Facilitate referrals to
appropriate community resources and healthcare providers. o
Collaborate with the Care Team to ensure timely follow-up and
service linkage. o Use designated online referral systems and
databases to track and manage client referrals. o Provide care
management related to social care services Accurately document in
electronic systems and maintain detailed and organized records in
compliance with organizational policies and standards. Work closely
with the Care Team, including care coordinators and other
healthcare professionals, to align to a whole person care approach.
Participate in regular team meetings and contribute insights on
client progress. Conduct proactive outreach to attributed Medicaid
members with open care gaps in preventive screenings, chronic
disease management, and follow-up care. Collaborate to support
performance under value-based contracts by engaging patients who
are overdue for services. Provide education to patients on the
importance of routine preventive care and chronic disease
monitoring to support improved outcomes and reduced avoidable
utilization. Assist patients with scheduling appointments,
arranging transportation, or connecting to community services that
reduce barriers to completing recommended care. Attend regular
supervision, staff meetings, trainings and other meetings, as
requested. Other duties as assigned Education & Experience: Minimum
of High School Diploma or GED. Associate's degree in human
services, Social Work or other related degree preferred. Equivalent
experience in lieu of education may be considered. Minimum of 1-3
years' human services experience. Skills, Knowledge, and Abilities:
Possess excellent verbal and written communication skills.
Exceptional customer service skills with commitment to helping
others. Ability to quickly adapt and be flexible in approach to job
tasks and challenges and maintain emotional control under stress.
Excellent time management skills with exceptional attention to
detail and the ability to multi-task and manage multiple priorities
with competing deadlines. Capability to work cooperatively with
culturally diverse clients, staff, and community service providers.
Basic computer literacy, including the ability to use email,
conduct online research, and create basic documents (MS Office
Suite including Excel, Outlook and Word). NYS motor vehicle
license, safe driving record and availability of personal vehicle
for work. Holds self and others responsible and accountable to meet
commitments. Salary Range: Salary is commensurate to education and
experience with a range of $18.27-$28.85 Additional information:
This position is an in-person role, embedded within Syracuse
Community Health a FLIPA member organization. This position will be
located at 930 S. Salina Street Syracuse, NY 13202.
Keywords: Forward Leading IPA, Syracuse , Community Health Worker - Syracuse Community Health, Social Services , Syracuse, New York