The Community Health Worker coordinates care between medical and behavioral health teams, connecting clients to resources and support to improve overall well-being through assessments and interventions. Responsibilities include ensuring grant compliance via accurate data entry, facilitating referrals, and coaching clients in self-care management.
Requirements summary
A High School Diploma is required, though a Bachelor's degree in social services is preferred, along with previous experience collaborating with community-based programs for individuals with behavioral health diagnoses. Working knowledge of Spanish is a mandatory requirement for this position.
high schoolbachelor degreeAdvocacyDocumentationData EntryCare CoordinationData CollectionTransitions of CareResource ConnectionBarrier ResolutionBehavioral Health InterventionsReferral FacilitationSocial Determinants of Health AssessmentGrant ComplianceRecovery Action PlanningTrauma Informed EnvironmentSelf-Care CoachingScheduling Screenings
Job description
Join a Team That Makes a Difference at Optimus Health Care!
Are you passionate about providing high-quality, patient-centered care? Optimus Health Care—the largest provider of primary health care services in Fairfield County—is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve.
Optimus Healthcare is looking for a Behavioral Health Community Health Worker to join our promoting integrated care team in our Bridgeport OB/GYN department. This grant funded position requires working knowledge of Spanish.
Position Summary
The PIC Community Health Worker ( Promoting Integrated Care ) works closely with medical and behavioral health care teams; fellow Optimus sites CHWs, and social services agencies to provide care coordination, connection to resources and support to improve clients’ health and general well-being. Works in both clinical and community-based settings. Under the supervision of the PIC Program Director, they assess and provide interventions to aid patients to cope with social, emotional, economic, and environmental problems.
Essential functions & responsibilities
1.
Completes social determinants of health assessments, person-centered recovery action plans oriented to the client’s cultural background including gender identity/sexual orientation.
Collaborate with teams to create a trauma informed environment for patients.
2.
Provides behavioral health resources and interventions when needed (ex: providing breathing exercises for anxiety or sleep hygiene suggestions) 3.
Ensure accurate and timely data entry to maintain compliance with grant requirements, including managing multiple Excel trackers/spreadsheets and entering, updating, and maintaining records within the grant-required database.
4.
Schedules and behavioral health screenings, face-to-face whenever possible and clinically appropriate.
Supports safe transitions of care for members moving between care settings.
5.
Works with primary care providers and other CHWs to facilitate referrals to behavioral health department, collaborates with patients to increase compliance with attending intakes, appointments and assists decreasing barriers to participation.
6.
Assists clients in the clinic setting.
Benefits
Health Insurance
Continuously identifies and resolves barriers to meeting goals and complying with the Individual Recovery Plan and reports barriers identified to the PIC Program Manager.
7.
Documents all client encounters and care coordination efforts made on behalf of clients; maintain comprehensive electronic client files in a consistent and timely fashion.
8.
Works with PIC team to provide accurate data collection for program reports as well as Optimus team-based care reporting needs.
9.
Coaches and facilitates communications with clients in effective management of self-care.
Assists clients in understanding care plans and instructions.
Motivates clients to be active and engaged participants in their health and overall well-being.
10.
May provide support and advocacy during medical and behavioral health visits or when necessary to guarantee clients' behavioral health and medical needs are being conveyed.
Follows up with both clients and providers regarding action plans.
11.
CHW will be held accountable and assessed by targeted measures from the PIC Grant.
12.
Facilitates client access to community resources, including housing, food, and clothing assistance, transportation, parenting, providers to teach life skills, vocational, educational resources, and relevant mental health services.
Assists clients in utilizing community services, facilitating appointments with community services agencies as well as with completion of applications for programs for which they may be eligible.
13.
Works collaboratively and effectively within the care team.
Establishes positive, supportive relationships with participants and provides feedback to other members of the team.
Builds and maintains positive working relationships with the clients, providers, nurse case managers, agency representatives, supervisors, and office staff.
Works to reduce cultural and socio-economic barriers between clients and agencies.
14.
Travels as needed to community locations, various agencies, and other outreach destinations.
15.
Attend meetings as scheduled or as requested.
16.
Participate in supervision with supervisor as required.
17.
Performs other duties as assigned.
Additional general requirements
Professional, positive attitude, understanding of customer service principles, intuitiveness, trustworthiness, and excellent interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position.
Knowledge of some medical terminology preferred.
Ability to understand the needs of the community to be served.
Must have knowledge of the various services available in the community.
Ability and willingness to provide emotional support, encouragement, and patient empowerment.
Ability to type into an electronic health record.
Job qualifications/Requirements
Education
High School Diploma required. Bachelor’s degree in social services preferred.
Experience
Previous experience in collaborating with community-based programs for persons with behavioral health diagnoses.
Preferred
Applicant has a well-developed understanding of chronic disease and its impact on behavioral/mental health treatment. Experience working with an ethnically, culturally, and racially diverse office staff and patient population.
Communication skills
Excellent interpersonal skills required including, but not limited to appropriate email etiquette, active listening, and thorough revision of all written assignments.
Licensure / Certification
Certification of Community Health Worker preferred.
Working for Optimus
OHC provides a fun, fast-paced working environment, where our commitment to quality is present in every job function.
100% Outpatient Setting
Excellent health & welfare benefit options
Competitive Compensation
Optimus and its caring, multilingual staff proudly serve our community in a patient-centered environment.
Optimus is committed to providing equal employment opportunities to all applicants and employees as protected by applicable federal and/or state law.
