Care Coordinator-HH536580
Institute for Community Living
- Brooklyn, NY
- $57,538 per year
- Permanent
- Full-time
- Conducts initial and ongoing assessments of assigned clients to document strengths, needs, goals, and resources.
- Participates in the development/documentation /review and update of client centered comprehensive integrated, interdisciplinary care plan in consultation with other team members to ensure focus on desired outcomes.
- Maintains effective communications with clients, primary care physicians, substance abuse, and mental healthcare providers, family, collateral resources and other Agency staff on behalf of clients.
- Maintains documents, records, statistics, and other related reports in an organized, timely, and accurate manner as per policy and procedure.
- Coordinates care planning with other providers of services/ resources to ensure goal directed, collaborative care, including care transitions.
- Works as part of a Care Coordination team; attends and participates in team meetings to provide input/feedback around psychosocial and medical conditions conditions/comorbidities to review client status, update plans and goals, review outcomes to further program goals.
- Acts as a resources/consultant to all team members on psychosocial, medical and/or substance abuse issues and resources.
- Provides telephonic as well as face-to-face outreach, engagement, and service planning in the field.
- Acts as a linkage to community services including medical, behavioral, residential, entitlement and any other needed services per interdisciplinary care plan.
- Monitors overall service delivery to clients to ensure coordination and continuity; advocates with service providers/resources as needed.
- Provides crisis intervention and follow-up.
- May be assigned other tasks and duties reasonably related to the job responsibilities.
- And other duties as may be assigned.
- Working knowledge of computer software and electronic health record systems
- Demonstrated competency in written, verbal, and computational skills to present and document records in accordance with program standards.
- Experienced in and demonstrated comprehensive understanding and working knowledge of the interdisciplinary planning process and the developmental treatment model.
- Knowledge of Medicaid, Social Security and other entitlements preferred.
- Excellent interpersonal skills required.
- You must have the ability and willingness to regularly travel, in some instances with clients in Agency vehicles, to many locations using various modes of reliable and safe transportation
- Specific training for the designated assessment tool(s), the array of services and supports available, and the client-centered service planning process. Training in assessment of individuals whose condition may trigger a need for HCBS and supports, and an ongoing knowledge of current best practices to improve health and quality of life.
- Mandated training on the New York State Community Mental Health Assessment instrument and additional required training.
- A NYS teacher’s certificate for which a bachelor’s degree is required; or
- NYS licensure and registration as a Registered Nurse and a bachelor’s degree; or
- A bachelor’s level education or higher in any field with five years of experience working directly with persons with behavioral health diagnoses; or
- A Credentialed Alcoholism and Substance Abuse Counselor (CASAC).
- In linking individuals with Serious Mental Illness, developmental disabilities, or substance use disorders to a broad range of services essential to successful living in a community setting (e.g. medical, psychiatric, social, educational, legal, housing and financial services).