Community Health Worker

Optimus Health Care•Bridgeport, CT

About The Position

Optimus Health Care is seeking a full-time, bilingual (Spanish) Community Health Worker in Bridgeport, Connecticut. The Community Health Worker (CHW) serves as a liaison among medical and behavioral health care, patients’ homes, and the community. The role provides individualized care management and coordination to support, improve, and maintain patients’ overall health and wellbeing. The CHW collaborates with care team members, social services agencies, and community partners to coordinate care and services, and works with culturally diverse populations. The position requires a personable, organized, self-directed worker with reliable transportation, strong verbal and written communication skills, a commitment to confidentiality, and flexibility to adjust their schedule when needed. The CHW welcomes new patients, helps them understand the Care Team model, conducts designated assessments and behavioral health pre-screenings, connects patients with community resources, and supports patient-centered care planning and self-management. The role also provides advocacy, helps coordinate transitions between care settings, and maintains detailed documentation in the Electronic Health Record (EHR), including encounter notes, care plans, screening tools, and relevant records. A high school diploma or equivalent is required. Experience working with ethnically, culturally, and racially diverse staff and patient populations is required. Community Health Worker training certification is preferred, or the employee must be able to obtain it within the first year of hire. Medical terminology knowledge, Spanish-English bilingualism, and experience with community-based programs serving people with serious psychiatric and addictive disorders are preferred. Eligible employees may receive medical, dental, and vision coverage, retirement benefits, paid time off, holidays, and other employer-sponsored benefits, subject to plan terms and eligibility.

Requirements

High school diploma or equivalent.
Experience working with an ethnically, culturally, and racially diverse office staff and patient population.
Strong verbal and written communication skills, including appropriate email etiquette, active listening, and careful revision of written assignments.
Strong interpersonal skills and ability to work with culturally diverse populations, including across race, ethnicity, gender identity, and sexual orientation.
Ability to understand the needs of the community served and knowledge of services available in the community.
Ability and willingness to provide emotional support, encouragement, and patient empowerment.
Ability to type into an electronic health record.
Highly personable, organized, and self-directed; must have reliable transportation.
Commitment to maintaining a high level of confidentiality.
Willingness to work a flexible schedule when needed.

Nice To Haves

Bilingual in Spanish and English.
Knowledge of some medical terminology.
Previous experience with community-based programs for people with serious psychiatric and addictive disorders.
Well-developed understanding of chronic disease and its impact on behavioral and mental health treatment.
Community Health Worker certification from a formal training program, or ability to obtain certification within the first year of hire.

Responsibilities

Welcome new patients, introduce the Care Team model, and complete designated assessments specific to patients’ cultural backgrounds.
Coordinate referrals to community resources, including housing, food, clothing, parenting classes, vocational services, and educational resources; assist with social-program redetermination forms.
Work with teams to create a trauma-informed environment for patients.
Perform initial behavioral health pre-screening.
Support safe transitions of care for patients moving between care settings.
Assist with creating, assessing, and re-evaluating patient-centered care plans that include self-management goals.
Coach patients in effective self-care and help them understand care plans and instructions.
Work with patients and their families or caregivers to support engagement in health and wellbeing.
Coach patients and families or caregivers on appropriate emergency department use and alternative options.
Participate in community health initiatives, health fairs, and other relevant events.
Attend scheduled or requested meetings and individual or group supervision.
Build and maintain positive working relationships with patients, care team members, and agency representatives.
Provide support and advocacy during office visits to ensure behavioral health and medical needs and referrals are conveyed.
Advocate for needed accommodations in school, home, community, and healthcare settings.
Assist youth transitioning to adult medical or behavioral health care.
Identify gaps in health services and coordinate comprehensive healthcare.
Collaborate with schools, community partners, homes, and healthcare providers to help achieve established goals.
Attend relevant community meetings to build collaboration and relationships with community members.
Document all patient encounters, including calls and discussions with collateral agencies, in the EHR using the DAP (data/assessment/plan) format.
Scan required documentation into the EHR, including releases, guardianship, health records, conservatorship, and IEP or 504 plans, when applicable.
Develop and update an integrated care plan with the care team.
Complete screening tools, such as CAGE, PHQ9, health literacy, and PRAPARE, annually.
Perform other duties as assigned.