ECM Care Coordinator

At Northern Valley Indian Health, our message has always been clear. At NVIH we have a culture based around prioritizing the health andwell-being of not just our patients and community members but ouremployees as well. From comprehensive insurance coverage, extensive paidtime off, and numerous supplemental benefits, NVIH has consistentlyshown employees how we value their personal and professional well-being.
We are a growing organization but will always remain firm in ourcommitment to employee health and well-being.

Salary:
$25.00 USD per hour
- $33.00 USD per hour Under the general supervision of the Supervising Care Coordinator, the Care Coordinator (CC) works collaboratively with other departments at NVIH to manage a caseload of patients requiring comprehensive and/or complex care solutions, with the ultimate goal of improving health outcomes. The CC provides care management services through various tools and methods, including conducting a patient intake for the Enhanced Care Management (ECM) program, connecting patients with necessary resources, building strong relationships with patients and their families, and following up based on patient needs. Strong collaboration with clinical care teams and operational teams is essential to ensure a holistic approach to patient support. Manage individual caseload by conducting comprehensive assessments of patient’s medical, behavioral, and social needs when referred for Enhanced Care Management services. Participate in developing individualized care plans, implementing the services, conducting follow-up, and monitoring the patient’s needs and care plan. Use motivational interviewing and other techniques to support behavior change and adherence to care plan. Coordinate with primary care providers, specialists, behavioral health professionals, and community-based organizations to support a patient-centered approach to care. Provide education and support to patients and their families about managing their health conditions and navigating the healthcare system, while empowering patients to take an active role in their care. Facilitate referrals, navigations, case management services, and linkages to community resources to address patient needs and follow up to ensure services are received and effective. Conduct or coordinate outreach activities in diverse community settings, fostering connections and expanding program reach. Maintain accurate and timely documentation of patients’ assessments, care plans, interactions and outcomes in accordance with regulatory and program requirements. Abide by current NVIH’s policies and procedures. Bachelor’s degree in Social Work, Psychology, Sociology or related field required. Minimum of one (1) year of experience in a healthcare case management or care coordinator role required; Proficient in reading, interpreting, and supporting complex care plans through critical thinking and sound judgement. Knowledge of clinical medical, behavioral Health and substance use disorder terminology is required. Demonstrated ability to grow and enhance personal and professional skills, as evidenced by achieving subject matter expert status in previous roles. Strong cross-departmental collaboration and teamwork skills to facilitate patient care coordination activities. Proven ability to engage with underserved communities in a culturally sensitive manner. Ability to effectively work independently with minimal supervision; Able to travel for training; must maintain a valid California driver’s license, meet agency auto insurance requirements, and have reliable transportation. Advanced computer skills with experience using Electronic Health Records (EHR) systems. Northern Valley Indian Health provides Native Preference in hiring practices for qualified Native applicants, in accordance with its policy. Northern Valley Indian Health is required to collect and maintain summary information on the gender, ethnic background, and veteran status of applicants. This information is confidential and will be used for statistical purposes only. Northern Valley Indian Health (NVIH), under the Indian Preference Act (Title 25, U.
In other than the preceding, NVIH provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national original, age, disability, or status as a Vietnam-era or special disabled veteran in accordance with applicable federal laws. In addition, NVIH prohibits discrimination on the basis of creed, sexual orientation, gender identity, marital status, or presence of a physical, mental, or sensory disability, in accordance with applicable state and local laws. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. #J-18808-Ljbffr Northern Valley Indian Health