Bilingual Community Based Care Coordinator

Neighborhood House • Portland, OR

5h • $51,853 - $54,733 • Onsite

About The Position

Neighborhood House is a non-profit agency providing social services for children, families, seniors, and people experiencing food and housing insecurity. We have been engaging in anti-poverty work for 120 years, offering a safety net to ensure that our community has the support they need to thrive.

Our Health-Related Social Needs (HRSN) program provides housing and tenancy support services for Oregon Health Plan (OHP) members across multiple Oregon counties, working in partnership with Coordinated Care Organizations (CCOs). Our primary focus is eviction prevention, supported by short-term case management and additional wraparound services.

The Community Based Care Coordinator works in direct service, responsible for delivering high-quality Health-Related Social Needs (HRSN) care coordination, including Outreach & Engagement (O&E) and Tenancy Supports. This role is essential in advancing Neighborhood House’s whole-person care approach, ensuring that clients receive timely, culturally responsive, and compliant support.

Requirements

• Strong interpersonal and communication skills to effectively engage with diverse clients, staff, and stakeholders.
• Demonstrated ability to work effectively with diverse populations, including immigrant and refugee families, and people from various cultural backgrounds.
• Ability to apply trauma-informed and culturally responsive approaches in client interactions.
• Capacity to serve as a peer trainer/coach, helping others adopt new systems and workflows.
• Ability to work independently while collaborating with a multidisciplinary team.
• Knowledge of health and social service systems, including Medicaid and community-based resources.
• Adaptability and flexibility to support ongoing program development and process improvements.
• Proficiency in Microsoft Office (Word, Excel), Outlook, Teams, and comfort learning and using client data/documentation systems.
• Ability to handle confidential and sensitive information with discretion and professionalism.
• Strong organizational and time management skills, with the ability to manage multiple tasks and deadlines.
• Minimum 3 years of experience in community health work, social work, case management, client advocacy, or social services.
• Bilingual in English and Spanish, or English and Ukrainian
• Proficiency in data entry, documentation, and maintaining organized records.
• Strong understanding of social determinants of health and barriers to accessing services.
• Experience in outreach, referral navigation, or connecting clients to health and social services.
• Experience working with unhoused individuals as well as vulnerable and disadvantaged populations.
• Associate’s degree in social work or related field, or equivalent experience.
• Valid driver’s license and car insurance that meets the requirements of NH’s auto insurance provider.
• Community Health Worker certificate

Nice To Haves

• Experience working with or within a community-based organization.
• Familiarity with Medicaid, the Oregon Health Plan, or HRSN services.
• Knowledge of documentation systems and program evaluation.
• Bachelor's degree in social work or related field.

Responsibilities

• Work with HRSN referrals to assess eligibility for the OHP HRSN Medicaid benefit and work with eligible clients to provide both short and long-term support.
• Provide Outreach and Engagement services, including screening for needs, creating short action plans, and connecting members to resources.
• Hold a case load of 28-30 clients (full time).
• Provide Tenancy Support and Procurement services once housing supports are authorized.
• Develop and update individualized care plans, incorporating client voice, goals, and priorities.
• Deliver trauma-informed, culturally responsive services with a strong equity lens.
• Maintain accurate, timely documentation of all client contacts in the client management system.
• Support clients with applications for HRSN services, benefits, or other resources.
• Coordinate warm handoffs with internal NH programs (Food Security, Education, Senior Services) and external partners.
• Attend and actively participate in required meetings and training sessions.
• Maintain timely and professional communication with coworkers, leadership, and stakeholders.
• Demonstrate regular and reliable attendance.
• Complete assigned work accurately and within established deadlines.
• Follow organizational policies, procedures, and safety requirements.
• Contribute to a positive, respectful, and team-oriented work environment.
• Perform other duties as assigned.

Benefits

• 26 days of PTO (increases with tenure) per year
• 12 paid holidays per year
• Kaiser health, vision, and dental insurance with low employee premiums
• 403b retirement plan
• Company-paid life insurance. Voluntary life, long-term disability, accident, and critical illness insurance.
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP) with free counseling

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree