BH Services Care Coordinator

About the role

Based at the Compton Wellness Center, the Behavioral Health (BH) Care Coordinator ensures timely, coordinated, and well-documented patient navigation and care coordination across all Integrated Behavioral Health (IBH) services, including therapy, psychiatry, and recovery services. This role is a key operational partner to the BH Fusion Lab, the department's Dramatic Performance Improvement (DPI) initiative to increase access, quality, and growth. Using patient-level data and caseload monitoring, identifies and corrects breakdowns that drive no-shows, long cycle times, low provider productivity, and Third Next Available (TNA) appointment delays; coordinates BH case manager and provider schedules; and works alongside clinicians, clinical supervisors, IBH case managers and staff, and Operations to remove barriers to care. The position cross-trains with the Operations department to align BH workflows with front-office, scheduling, and patient-flow processes.

Responsibilities

• Supports BH Fusion Lab goals of increasing access, quality, and growth by helping providers reduce no-shows, increase productivity and completed visits, reduce cycle time, and improve Third Next Available (TNA) appointment metrics.
• Tracks and analyzes patient-level and site-level data on patient flow, scheduling, no-show, and cancellation patterns, referral completion, and outcomes; identifies breakdowns and recommends and implements corrective actions.
• Provides day-to-day oversight of provider schedules across all IBH services, including template optimization, appointment reminder and confirmation workflows, waitlist and cancellation backfill, and same-day access.
• Participates in rapid-cycle improvement (PDSA) work, learning sessions, huddles, and data reviews; helps standardize and spread successful workflows across IBH sites.
• Supports the improvement of service delivery across all IBH services, including recovery services, and contributes to grant deliverables and quality measures (e.g., UDS depression screening and follow-up, HEDIS behavioral health measures).
• Works alongside clinicians, clinical supervisors, psychiatry providers, peer recovery specialists, Community Health Workers, grants teams, and all departments, especially Operations, to coordinate care and resolve barriers to access.
• Cross-trains with the Operations department to understand front-office, call center, scheduling, registration, and eligibility workflows, and to align BH processes with clinic operations.
• Coordinates care monitoring and follow-up schedules with families and maintains contact between families and service providers to monitor progress.
• Attends and contributes to staff meetings, case conferences, interdisciplinary team meetings, and open discussion forums; fosters a collaborative, patient-centered, and advocacy-oriented team environment.
• Participates in continuing education and professional development and maintains current knowledge of behavioral health navigation, care coordination, and payer requirements.
• Provides navigation support across all IBH services, including warm hand-offs from primary care, engagement of patients with positive screens, and re-engagement of patients lost to follow-up.
• Coordinates access, and internal and external referrals, and confirms closed-loop referral completion.
• Links patients to community resources (housing, food, benefits, legal, employment, education) and Medi-Cal managed care benefits such as CalAIM Enhanced Care Management (ECM) and Community Supports where eligible; serves as liaison between patients, families, and community partners.
• Ensures continuity of care across IBH programs, primary care, psychiatry, recovery services, and transitions of care (e.g., post-hospitalization, crisis stabilization, residential treatment).
• Facilitates patient IBH record and form requests, obtains ROI and uploads all documents to patient chart.
• Provides Spanish interpretation as needed.
• Ensures patients have completed intake of paperwork, consents, releases of information, and program enrollment forms prior to initial assessment.
• Monitors screening and re-screening completion rates and follows up on missed or overdue measures.
• Maintains accurate, complete, and confidential records, client tracking logs, and data collection in compliance with organizational requirements and documentation standards.
• Maintains regular contact with patients through phone, text (where consented), and outreach; documents all contacts and attempted contacts.
• Prepares monthly caseload, productivity, and outcome reports for IBH leadership and grants teams.
• Maintains Time Study, if necessary.

Qualifications

Education: Bachelor's Degree

Experience: (Required) Three years' experience in social service setting providing targeted care management to multi-ethnic communities. Preferred: Certified Case Manager (CCM), Community Health Worker certification. Bilingual English/Spanish strongly preferred, consistent with the patient population served.

Licensure/Certification: Employees are responsible for maintaining individual certifications as required by job function or by law and provide verification and recertification when requested by management.