Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.
Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.
In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.
Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.
Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.
- Aim for Understanding
- Be All In
- Bring Your Whole Self
- Lean Into Discomfort
- Put Members First
About our Team:
We employ a field-based, home-based care model and are committed to meeting members where they are--in their homes, in their community, and in our Hubs. You will go above and beyond to connect with Cityblock members in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day.
About the Role:
- You will work in a radically different model of healthcare
- Expect collaboration, shared-decision making, and partnership across clinical and non-clinical care team members, including our large team of Community Health Partners
- As a full-time employee, you should aim to spend approximately 20 hours of your time on Direct Patient Care (visits) in order to comply with weekly appointment goals. This should be adjusted based on member need.
- Co-manage a population living with complex medical and behavioral health conditions
- Work a full-time 40 hour week, Monday-Friday 9am to 5pm ET with one late evening a week shared amongst the Behavioral Health team. Your work may take you outside of normal business hours as urgent member needs arise.
- Provide individual and group therapy, consultations and community referrals, crisis interventions, and safety assessments for members
- Support existing services in the community or work as the bridge to longer-term behavioral health services
- Actively participate in daily team huddles and weekly case conferences to advise on behavioral health needs and establish Behavioral Health goals as part of member’s Member Action Plan (MAP)
- Follow up on Behavioral Health referrals from the Community Health Partner team - schedule 1:1 therapy sessions with members
- Actively participate in planning and/or implementation of initiatives related to Behavioral Health integration and collaboration with external vendors, community-based service providers, and/or the larger Cityblock Care Team
- Be the point person for the members on your panel with significant behavioral health diagnoses - be available over phone, email, and in-person for your Care Team
- Develop and lead programming therapy groups for Cityblock members
- Utilize our custom-built care facilitation platform, Commons, and the market’s EMR, documenting notes, tracking tasks and communicating with other members of the care team. Documentation should be complete within 72 hours of a member visit or encounter
Requirements for the Role:
- You have a LCSW or PsyD in the state in which you are seeking employment with Cityblock
- Experience working with individuals with co-occurring chronic medical and chronic behavioral health diagnoses
- Direct familiarity with clinical settings and experience with home-visiting/care in the field
- You have experience providing direct mental health treatment, substance use treatment, or both
- You are an independent self-starter, a leader, and a strategic thinker who is excited about the big picture of whole community health, and the ongoing evaluation and iteration of our care model
- You have experience (formally or informally) providing supervision to social workers, community health workers, or care coordinators, and are interested in growing your supervision skills
- You are excited about how technology can support your work and help drive the ongoing evaluation toward new, better, care
How We Define Success:
- Manage a complex population of members in collaboration with an interdisciplinary team
- Ensure members on your panel receive appropriate care for acute behavioral health conditions, including following ED visits and acute admissions
- Decrease unnecessary hospitalizations, emergency room visits, and unnecessary speciality referrals
- Support care team with transitions of care
- Conduct initial Behavioral Health provider visits with Cityblock team members to ensure proper needs assessments
- Meet evolving monthly and quarterly targets for visits with Cityblock members, in both clinic and home setting
- Engage in target setting for new clinical initiatives and managing those targets
Nice to Have, But Not Required:
- You have experience in a specialized field (trauma-informed care, substance use, psychosis, etc.)
- Experience with substance use disorder treatment
- Experience caring for individuals experiencing homelessness
- Experiencing caring for individuals with criminal justice involvement
- Comfort using new technologies in healthcare
- Interest or experience in healthcare assessments and evaluation
- Interest or experience in analysis of healthcare data
What We’d Like From You:
- A resume and/or LinkedIn profile
- A short cover letter, please!
Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.