Patient Care Coordinator

Responsibilities

• Guide discharge and transition planning efforts by partnering with clinical staff to prepare clients for the next stage of care.
• Evaluate each client’s post-treatment needs and create tailored plans that address housing, services, benefits, and follow-up support.
• Connect individuals with community programs, aftercare providers, placement options, and case management resources to help maintain continuity of care.
• Cook up communication with external partners such as county programs, legal contacts, financial support representatives, and utilization review teams.
• Confirm that coverage, referrals, financial assistance, and related support services are in place before discharge is finalized.
• Maintain accurate and timely records, including discharge documentation, summaries, and status updates required for care coordination.
• Participate in team meetings to report on barriers, progress, and outstanding social service needs affecting discharge readiness.
• Build supportive, collaborative relationships with clients and families while helping them understand available services and next steps.
• Stay informed on local behavioral health and social service resources by engaging with community organizations and referral networks.

Requirements

• At least 2 years of experience in behavioral health, social services, case coordination, discharge planning, or a related public service environment.
• Bachelor’s degree in Social Work, Psychology, Human Services, or a closely related field is preferred.
• Familiarity with mental health populations, psychiatric care approaches, and community-based support systems is strongly preferred.
• Ability to manage referrals, appointment coordination, patient-related documentation, and follow-up activities with strong attention to detail.
• Working knowledge of HIPAA standards, patient privacy practices, and documentation accuracy requirements.
• Strong verbal and written communication skills with the ability to collaborate effectively across multidisciplinary teams and outside agencies.
• Experience verifying benefits, coordinating insurance-related referrals, and helping clients access needed services is preferred.
• Licensure is a plus.

Qualifications

The ideal candidate brings strong follow-through, sound judgment, and the ability to work closely with interdisciplinary teams, families, and outside agencies to promote safe and effective transitions.