Care Coordination Specialist

17 hours ago


Brooklyn, New York, United States Housing Works Full time
About the Job

The Care Manager at Housing Works plays a vital role in guiding clients with chronic illnesses through the healthcare system. This position requires excellent interpersonal, public speaking, and written communication skills, as well as the ability to work autonomously and demonstrate professionalism, respect, and teamwork. If you are passionate about delivering exceptional patient care and working in a collaborative environment, this may be the ideal opportunity for you.

Responsibilities
  • Conduct initial assessments and periodic reassessments of clients' needs, including medical, mental health, substance use, financial, housing, and support needs.
  • Develop patient-focused care plans with documented input and approval from other providers and the client, in compliance with Health Home standards.
  • Work with the medical staff to develop, implement, and coordinate the care plan for clients with chronic illnesses, such as diabetes, asthma, congestive heart failure, hypertension, behavioral health conditions, and HIV, among others.
  • Conduct home/field visits and maintain client engagement in accordance with program standards.
  • Coordinate client services with internal and external service providers through regular case conferencing.
  • Document client outcomes from the care plan in the case record and ensure appropriate record documentation for the entire caseload.


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