St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Chronic Disease Community Health Worker (CHW) will be responsible to provide education according to priorities established through our Community Health Needs Assessment (CHNA) while assisting patients to navigate and access community services and resources They will promote healthy behaviors for chronic disease prevention and management. The Chronic Disease CHW supports nurses, providers, liaisons, case management, and the clinical care team with an integrated approach to education and community outreach and partnership and provides social support, informal counseling, and education while advocating for individuals and community needs. JOB DUTIES & RESPONSIBILITIES: Work in conjunction with the Community Health and Diabetes Self- Management, Education and Support (DSMES) team to identify patients/families requiring assistance in navigation, care coordination, insurance connection, and additional needs identified in Social Determinants of Health (SDOH) Assessment. Follow requirements for the Diabetes Education Accreditation Program (DEAP). Responsible for establishing trusting relationships with patients and their families while providing general support and encouragement. Work closely with healthcare team, under the direction of the Network Director Community Health Clinical Operations to help ensure patients have coordinated care. Provide disease-specific education during 1:1 or group sessions with patients under the direction of the department’s providers. This includes but is not limited to diabetes and hypertension. Provide ongoing follow-up and resource connection with patients/families. Register, schedule, check-in, and check-out patients according to Electronic Health Record (EHR) requirements. Complete accurate documentation of all encounters in EPIC. Assess the needs of referrals and determine eligibility for services, according to government and local program guidelines. Maintain responsibility for own development through active participation at in-services and/or continuing education programs. Function as a professional role model and resource person providing guidance to co-workers. Participate in department Quality Improvement activities. Maintain confidentiality of all materials handled within the Network/ Entity as well as the proper release of information. Comply with Network and departmental policies regarding issues of employee, patient and environmental safety and follows appropriate reporting requirements. Demonstrate/model the Network’s Service Excellence Standards of Performance in interactions with all customers (internal and external). Demonstrate Performance Improvement in the following areas as appropriate: Clinical Care/Outcomes, Customer/Service Improvement, Operational System/Process, and Safety. Demonstrate financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes and practices. Comply with Network and departmental policies regarding attendance and dress code. Other duties as assigned. PHYSICAL & SENSORY REQUIREMENTS: Sitting for up to eight hours per day, up to two hours at a time. Walking for up to one hour per day up to 15 minutes at a time. Involves frequent fingering, firm grasping, handling and twisting and turning. Occasional lifting and carrying objects up to 25 pounds. Occasional stooping, bending and reaching above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general vision, color vision, peripheral vision and visual monotony. Must have the ability to sit for 2 total hours per day, and up to 1 total consecutive hour. Must be able to stand for 6 total hours per day and up to 4 total consecutive hours. Must be able to walk 6 total hours per day and up to 30 total consecutive minutes. Must have the ability to frequently use fingers/hands. Must have the ability for touching as it relates to feeling objects by touching with the skin, particularly that of fingertips. Must have the ability for hearing as it relates to normal conversation, high frequency and low frequency hearing sounds. Must have the ability for seeing as it relates to general vision, near vision, color vision and peripheral vision. EDUCATION: High School Graduate/GED required; Bachelors Preferred. Successful completion of a network approved Community Health Worker/Care Coordinator training required within one year of hire or within one year of this job description adoption. TRAINING & EXPERIENCE: 1-2 years of experience working in a community-based setting. Knowledge of medical terminology required. Fifteen hours of training in diabetes management required within four months of hire date. Spanish preferred. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer. Founded in 1872, St. Luke’s University Health Network (SLUHN) is a fully integrated, regional, non-profit network of more than 23,000 employees providing services at 16 campuses and 350+ outpatient sites. With annual net revenue in excess of $4 billion, the Network’s service area includes 11 counties in two states: Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe, Schuylkill and Luzerne counties in Pennsylvania and Warren and Hunterdon counties in New Jersey. St. Luke’s hospitals operate the largest network of trauma centers in Pennsylvania, with the Bethlehem Campus being home to St. Luke’s Children’s Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare’s five-star ratings (the highest) for quality, efficiency and patient satisfaction. It is both a Leapfrog Group and Healthgrades Top Hospital and a Newsweek World’s Best Hospital. The Network’s flagship University Hospital has earned the 100 Top Major Teaching Hospital designation from Premier 13 times total and eleven years in a row, including in 2023 when it was identified as THE #4 TEACHING HOSPITAL IN THE COUNTRY. In 2021, St. Luke’s was identified as one of the 15 Top Health Systems nationally. St. Luke’s is the ONLY health care institution in the Lehigh Valley to be named a Top Workplace regionally repeating the exclusive honor for the third year in a row. Also, for the third straight year, St. Luke’s has been a Top Workplaces in the Philadelphia Region by the Philadelphia Inquirer, ranking 9th in the large employer category for 2025 and the only health care system in PA to receive this award. In 2025, St. Luke’s was recognized as a national Top Workplaces by USA Today, three years in a row, including the 3rd best health care system in the nation in 2023 and 2024. Lastly, in 2025, St. Luke’s was named a Top Workplace in New Jersey for the third year in a row. Learn More Here.

Chronic Disease Community Health Worker (Bilingual-Spanish preferred).

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