Care Coordinator

2 weeks ago

New York, New York, United States POSTGRADUATE CENTER FOR MENTAL HEAL Full time
Job Title: Care Coordinator

Join the Postgraduate Center for Mental Health as a Care Coordinator and play a vital role in providing intensive services to members on court-ordered Assistant Outpatient Treatment (AOT) status.

Job Summary:

The Care Coordinator will work under the supervision of the Program Supervisor to address all member needs, provide care plan updates, conduct outreach to members, and regularly communicate with collaterals. The successful candidate will advocate and support members, engage with community agencies and healthcare providers, and ensure access to services needed to increase wellness self-management, reduce emergency room visits and hospitalizations, and keep members safe within the community.

Key Responsibilities:
  • Coordinate care for a caseload of approximately 12 to 15 AOT mandated members
  • Provide face-to-face contact at least once per week
  • Communicate with managed care plans about their members
  • Collaborate with each member's assigned AOT worker, including the timely submission of weekly reports, monthly verbal status updates, and significant event reports
  • Comply with all statutory reporting requirements under Kendra's Law
  • Ensure transitions and service engagement comply with the individual's AOT order
  • Timely completion of CAIRS assessments
  • Establish and maintain effective communication with primary and specialty care physicians, substance abuse and mental healthcare providers, family, collateral resources, and other Agency staff on behalf of members
  • Maintain documents, records, statistics, and other related reports in an organized, timely, and accurate manner as per policy and procedure
  • Conduct initial and periodic needs assessments, including assessing barriers and assets
  • Assist with the development and execution of member's care plans, including assisting members in understanding care plans and instructions and tailoring communications to appropriate health literacy levels
  • Record client progress according to measurable goals described in his/her care plan
  • Assist members with accessing healthcare and social systems, including arranging for transportation and scheduling and accompanying members to appointments
  • Assist members with identifying available community-based resources and actively manage appropriate referrals, access, engagement, follow-up, and coordination of services
  • Assist with coordinating members' access to individual and family supports and resources
  • Assist members with managing daily routines related to healthcare and incorporating members' strengths and identifying barriers
  • Assist with conducting outreach and engagement activities that support continuity of care, including re-engaging members in care if they miss appointments and/or do not follow-up on treatment
  • Provide crisis intervention and follow-up
  • Monitor member entitlements, insurance, and other benefits to ensure they remain active and in place
  • Advocate for members to resolve crises
  • Collaborate with other professionals to evaluate members' medical and/or behavioral health condition and to assess member needs
  • Responsible for the on-call 2 to 3 weeks out of the year
  • Manage wrap-around funds, metro cards, and checks for member purchases, including obtaining the necessary approvals for all purchases in keeping with the member's goals
Requirements:
  • Bachelor's degree in one of the following fields: [list of fields]
  • NYS teacher's certificate for which a bachelor's degree is required
  • NYS licensure and registration as a Registered Nurse and a bachelor's degree

The ideal candidate will possess excellent oral and written communication skills, strong engagement and advocacy skills, flexibility, and good crisis intervention and management skills. They will also have excellent interpersonal skills, the ability to use good judgment in seeking supervisor assistance when appropriate, and be well-organized with attention to detail. The ability to work effectively to manage workload under pressure and meet deadlines is essential. Ability and willingness to travel regularly, in some instances with clients, to many locations using various modes of reliable and safe transportation is also required. Ability to work with multiple electronic health records is a must.

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