Care Coordinator

JOB RESPONSIBILITIES

• Meet individually with MAT clients when needed and document interactions
• Liaison with medical staff
• Work closely with staff regarding their MAT patients
• Implement discharge plans as formulated by the treatment team, for example, arranges for appointments with outpatient MAT providers
• Creates and maintains database of information regarding discharge dates, appointment times/dates/locations
• Communicates with the treatment team regarding all relevant discharge information to provide continuity of care
• Communicates all needed information to aftercare referral sites in a complete and timely manner.
• Records all patients follow up within 7 days of discharges
• Reports all incidents of suspected abuse using prescribed forms and protocols from the relevant community/state agency
• Conduct follow-up calls with Protective Agencies; assists agency in obtaining necessary information
• Delivers education on relevant topics (MMT, MAT, Suboxone, Vivitrol, etc.) to current and potential clients and/or referral sources
• Charts are completed and monitored through supervision
• Contact appropriate individuals at admission and discharge to exchange pertinent information
• Conduct psychosocial assessments to document history and identify preliminary issues for treatment focus through interview process
• Provides group and family process-oriented therapies using various professional treatment modalities
• Develop/Coordinate Individualized Discharge Plan
• Update resident charts describing therapy performed, progress in discharge planning process or other interventions
• Schedules, attends and documents court hearings
• Responds to psychiatric emergency codes utilizing training in management of aggressive behavior
• Attends regular treatment team meetings to provide social work perspective to total case management of the resident and state or local agency legal requirements
• Provide backup services for incoming assessment and referral calls
• Meets on a regular basis with supervisor
• Participates in training and development for purpose of professional growth and skill enhancement

Center of Excellence (COE)

• Provide consistent, evidence-based care to individuals seeking treatment for opioid use disorder by following established guidelines to ensure that individuals receive the most effective and up-to-date treatments, increasing the likelihood of successful recovery.
• Facilitate better coordination among staff to ensure that individuals receive comprehensive and integrated care, addressing both their medical and psychosocial needs.
• Encourage patients to maintain relapse prevention skills by maintaining engagement post discharge with their COE representative.
• Engage individuals with a history of emergency department (ED) treatment episodes for opioid use; individuals with a history of inpatient or residential substance use treatment; individuals with a high risk for overdose; individuals with opioid use in addition to polysubstance use; and individuals with current intravenous drug use.
• Focus on high-risk priority populations such as pregnant women, individuals recently released from incarceration, individuals with intravenous substance use, individuals with acute or chronic homelessness or housing instability, individuals with a history of opioid overdose, and Veterans.
• Integrate interventions for mental health and substance use, and behavioral and physical health.

QUALIFICATIONS

• Bachelor's degree in human services or sociology, political science, criminal justice, pastoral counseling, education or related field
• A minimum of 1-year direct care experience.
• Experience in an in-resident setting preferred
• Written and oral communication skills
• Skills in case management, time management, and crisis intervention
• Experience in provision of group and individual psychotherapy
• Ability to maintain information confidentially

PHYSICAL AND MENTAL JOB REQUIREMENTS

Ability to stoop, kneel, crouch, reach, walk, push, pull, lift, moving about in work area and throughout residential to accomplish tasks, finger (i.e., pick or type) and grasp. Ability to express and exchange ideas via spoken word, conveying information to others in an audible, accurate and, on occasion, quick manner. Able to perceive the nature of sounds within less than 40db, loss at Hz, 1000 Hz and 2000 Hz with or without correction; perceive detailed information through oral communication and to make fine discriminations in sound. Perform repetitive motions with wrists, hands and fingers.

Work is primarily sedentary in nature, requiring occasional exertion of up to 10 pounds of force to lift, carry, push, pull or otherwise move objects.

Work requires visual acuity to read, prepare, and analyze data, transcriptions, and characters on computer terminals, visual inspection of documents, and similar objects or items at distances generally close to the eyes.

Worker is not substantially exposed to adverse environmental conditions; conditions are typical of office settings and administrative work.

Must be able to concentrate on work amid distractions such as noise, conversations, and foot traffic; must be able to consistently meet deadlines regardless of case load; must be flexible in work hours in order to meet resident and residential operating needs.

Must maintain self-control in volatile or hostile situations such as when verbally or physically confronted.

Must be able to set therapeutic limits and maintain therapeutic distance with clients.

Must be able to address and prioritize multiple tasks demands within established time frames