Care Management Coordinator - MSW

Job Responsibility Implement and sustain the evidence-based HealthySteps model in supporting families of children ages 0-5 with development, learning and growth, and overall wellbeing, in conjunction with the pediatric primary care team. Join and participate in in‑person team‐based well visits to reach families during primary care appointments. Create and maintain an up‑to‑date community partnership and resource directory. Maintain a HealthySteps family support line and respond to and track call requests within the designated response time. Provide appropriate referrals to families for support with individualized needs. Appropriately document all clinical activities and care coordination in the electronic health record with consideration to patient confidentiality. Attend and participate in team meetings, huddles, and patient care meetings as appropriate. Track caseload to ensure capacity to deliver HealthySteps services within the delivery model. Ensure that when termination criteria are met and/or escalate families requiring further support to higher levels of care through the health system and community referrals, as appropriate. Use team‑based communication strategies to close the loop on referrals and follow up for outstanding patient needs. May facilitate caregiver support groups as appropriate. Participate in reflective clinical supervision meetings. Maintain accurate records of caseload data as appropriate for program management, evaluation, and reporting purposes. Job Qualification Master’s degree in social work or related field, required. NYS Licensure required within 6 months of hire, if applicable. 1-3 years of relevant experience working with children and families, required. Successful completion of the HealthySteps Specialist training within 6 months of hire. Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). #J-18808-Ljbffr