Care Coordinator

About the Role

The Jewish Board’s Community Care Management programs provide compassionate, high-quality, evidence-based services to individuals and families. Care Coordinators link adults and children with chronic behavioral health and medical conditions to the services they need to stay as healthy as possible. Working in a team setting and primarily in the field, Care Coordinators assess risk and needs, develop person-centered care plans, provide care management services, track and arrange appointments, educate members, and coordinate health and community services. As this is an evolving program, additional responsibilities will be added.

Responsibilities

• Integration of medical, specialized, and behavioral health services in addition to social support and/or educational support services
• Periodic assessment of a member’s medical and behavioral health needs as well as compliance with recommended treatments
• Collaborative development of an Individualized Care Plan (ICP) with the member, the member’s family and/or caregivers, and other service providers
• Providing required care management services
• Tracking all specialty medical, behavioral, and support service referrals using Health Information Technology (HIT)
• Ensuring members have access to, engage in, and retain needed services as defined in the ICP, including:
  • Acute Medical Care
  • Primary Medical Care
  • Preventative medical care services (including metabolic screening)
  • Home Health Care
  • Chemical Dependency Services
  • Behavioral Health Services
  • Community social support services
  • Housing
  • State and federal entitlements
  • Educational services
  • Involvement with child welfare, juvenile justice, or criminal justice institutions
• Providing outreach services to members for increased access to services
• Responding to members’ information and referral questions
• Reassessing the need for ongoing care coordination services
• Completing all required documentation
• Sharing knowledge and experience with other team members to support service provision
• Carrying an agency-provided cell phone
• Responding to member crises during (and occasionally outside of) regular business hours
• Other duties as assigned

Core Competencies

• Positive attitude and a growth mindset
• Ability to engage with clients and peers and provide culturally competent services
• Strong verbal and written communication skills
• Attention to detail
• Ability to work independently and within a team
• Ability to partner with clients to conduct assessments and create care plans
• Strong time management and organizational skills
• Integrity and transparency
• Ability to exercise strong professional judgment

Requirements

A bachelor's degree with a major or concentration (minimum of 24 credits) in one of the following fields:

• Social work
• Psychology
• Nursing
• Rehabilitation
• Education
• Occupational therapy
• Physical therapy
• Recreation or recreation therapy
• Counseling
• Community mental health
• Child and family studies
• Sociology
• Speech and hearing

OR a NYS teacher's certification for which a bachelor's degree is required; OR NYS licensure and registration as a Registered Nurse and a bachelor's degree.

PLUS one of the following:

• Two years of experience in providing direct services or case management services to mentally disabled, chronically ill, homeless individuals, or children with complex social or healthcare needs.
• A Bachelor’s Degree, Associates Degree, or High School Diploma/GED in another discipline PLUS five years’ experience working with an applicable population. Specific experience with the target population may be required for Children, Health Home Plus, or Adult Home Plus members.

Preferred Qualifications

• Experience working in interdisciplinary teams
• Experience providing care management or care coordination in a medical or behavioral health environment
• Experience working with the chronically ill
• Fluency in a second language such as Spanish, Russian, or Creole

Skills

• Use of an Electronic Health Record (EHR)
• Use of Outlook and related Microsoft Office Applications
• Visual and manual dexterity for reading documents and performing data entry

Work Environment

The work environment varies from office-based interactions (20-40% of the time) to serving members in their homes and other community settings (e.g., hospitals, clinics, benefit offices) 60%-80% of the time. While the Jewish Board’s offices are ADA-accessible, some community sites may not be.

• Must be able to travel within New York City carrying equipment such as a notebook, forms, laptop, mobile hotspot, and cell phone (up to approximately 10 pounds).
• Routinely required to sit (60% of the time) and stand (20% of the time).
• Must travel to and from appointments using varied public and private transportation options (20% of the time).
• Risks/hazards associated with the position include those encountered while traveling around New York City.