Care Coordinator - Street Team

Job Summary

Hours: Full-time, Monday-Friday; 08:30am -5:00pm
Union: Yes
Union Name: 1199 SEIU
Patient Facing: Yes

Responsibilities

• Provide outreach-based care coordination and non-judgmental support in collaboration with other Street Team members
• Engage individuals experiencing substance use disorders and mental health conditions using low threshold principals and trauma-informed care practices.
• Conduct health and needs assessments and collaborate with patients and the primary care team to develop and implement integrated care plans
• Assess social determinants of health (e.g., housing, food access, benefits, transportation) and support patients in addressing these needs based on their goals and priorities
• Cookordinate as needed with outreach and housing partners to address social determinants of health for shared patients.
• Track patient appointments, referrals, and primary care; follow up with patients to support appointment adherence or rescheduling when appointments are missed
• Conduct street outreach and home visits with Street Team as necessary
• Represent the Street Team at housing-related meetings with the City of Boston and other partner agencies regarding unsheltered patients empaneled to the Street Team
• Coordinate and facilitate monthly meetings with housing partners regarding patients currently housed and empaneled to the Street Team
• Successfully complete the MassHealth Certified Application Counselor exam (CAC) within 60 days of hire and maintain active certification status.

Requirements

• Experience working with vulnerable populations, including people with a history of trauma, those experiencing socioeconomic stress, homelessness, mental health challenges, or substance use disorders
• Strong interpersonal skills and case management problem-solving
• Efficient, organized, detail-oriented, and able to complete tasks in a time-sensitive manner
• Self-directed with the ability to work both independently and collaboratively with clinical staff on shared patient goals

Qualifications

• Bachelor’s degree preferred but not required
• Demonstrated commitment to working with underserved and vulnerable populations
• Ability to work collaboratively as part of a multidisciplinary healthcare team using a coordinated, patient-centered approach
• Ability to manage a fast-paced workload, prioritize tasks, and maintain professionalism in stressful or unpredictable situations
• Self-motivated with the ability to work both independently and collaboratively with team members across multiple locations
• Ability to travel regularly between outreach locations and access community sites
• Ability to use standard office and field technology, including computers, tablets, and telephones, for documentation and communication
• Ability to lift and carry 5–10 pounds regularly and up to 15–20 pounds occasionally
• Ability to climb stairs, bend, stoop, and navigate uneven terrain commonly encountered during community and street outreach
• Ability to walk 5+ miles/day in all weather conditions—you will do street outreach outside in all seasons

Benefits

The compensation increases based on years of experience and ranges from $22.25 - $35.60 hourly

BHCHP full time employees are eligible for our competitive time off program, health, dental and vision insurance, 403B retirement savings plan, pre-tax MBTA pass program with 40% discount, additional compensation for demonstrated bilingual proficiency and more. Benefits are prorated for part-time employees

Pay

The compensation increases based on years of experience and ranges from $22.25 - $35.60 hourly

Schedule

Hours: Full-time, Monday-Friday; 08:30am -5:00pm