Care Coordinator
3 weeks ago
Boston Health Care for the Homeless Program is seeking a compassionate and dedicated Care Coordinator to join our team. As a Care Coordinator, you will play a vital role in connecting homeless individuals with serious mental illness, substance use disorders, and/or complex medical illnesses with needed care, including mental health, substance use, and primary care, as well as services that address social determinants of health needs.
This is a hybrid remote/in-office work possibility.
In this role, you will work closely with an interdisciplinary team to coordinate care for up to 50 enrollees, engaging them regularly and helping them progress on goals identified in their Person-Centered Care Plan. You will also work with nurse care managers to conduct timely Comprehensive Assessments and document enrollee progress on Care Plan goals.
Responsibilities:
- Communicate and engage with enrollees regularly and help them progress on goals identified in Patient Centered Care Plan
- Work with the nurse care managers, conduct timely Comprehensive Assessments
- Document into data platform regarding enrollee progress on Care Plan goals, all enrollee encounters, care coordination notes
- Assist nurse care managers and BH CP teams with arranging enrollee appointments for services needed and other related assessments; accompanies enrollees to appointments as needed
- Triage and troubleshoot care need issues for enrollees; works with nurse care managers to address needs
- Participate in team case conferences and advocate for enrollees' needs
- Participate in BH CP training and learning collaboratives
- Remind enrollees about keeping appointments, filling prescriptions, etc.
- Work with BH CP team on dev & implementation of Patient Centered Care Plan
- Request & send medical records to for care coordination purposes to providers, ACO, MCO as needed
- Be flexible and able to multi-task
- A Bachelor's degree in social work, human services, nursing, psychology, sociology, or related field; or an Associate's degree and at least one year professional experience in the field; or at least three years of relevant professional experience
- Excellent customer service skills and the ability to communicate professionally with employees and enrollees both on the phone and in person
- Efficient, organized, detail oriented, and able to complete tasks in time sensitive manner
- Self-directed with the ability to work both independently and as part of a team and interested in using data to help direct care
- Motivational Interviewing and Cultural Competency training a plus; experience working with homeless populations and/or populations with mental illness and substance use disorders
- Experience in case management or human services is preferred but not required
- Computer skills: Proficient with Microsoft Excel Spreadsheets, entering narrative and other data into a database, the use of the Internet to conduct information searches
- The compensation starts at $22.07 and increases based on years of experience
- BHCHP full time employees are eligible for our competitive time off policy of 4 weeks' vacation, health, dental and vision insurance, 403B retirement savings plan and employer retirement contribution, and pre-tax MBTA pass program with 40% discount
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