Bilingual Spanish Intensive Care Coordinator - Health Home Plus

Position Summary: The Intensive Care Coordinator (ICC) provides assessment, care planning, and service coordination activities for eligible clients, with significant behavioral health, mental health, and/or medical needs. The ICC works closely with other health and social service providers to ensure comprehensive and appropriate care needs are met to stabilize participants, promoting access to health and wellness while reducing healthcare costs.

Responsibilities:

• Monitor progress of each client on an ongoing basis through delivery of face to face, escort, written, electronic and telephonic outreach/monitoring/collaboration and planning activities, in accordance with Health Home, DOH, OMH, and departmental guidelines.
• Complete client-centered comprehensive functional assessments to identify the medical, behavioral health, and social needs/goals of each client.
• Develop, adhere to, and document daily schedule of appointments; inform supervisor of scheduling conflicts or changes and maintain accurate record of daily activities.; participate in individual and group supervision as scheduled by the appointed supervisor.
• Develop, review, and update written/electronic person centered care plans that are driven by functional assessment outcomes. Shared and develop/update care plan in partnership with the client and their Health Home network partners and collateral supports. Ensure that all Care Plans uphold the policy and procedure set forth by the department and Health Home.
• Maintain an accurate caseload panel through prompt identification and response to cases appropriate for level of care changes including but not limited to discharge or transfer activities.
• Maintain collaborative relationships with all service providers utilized in the care planning interventions, sharing/extracting regular status updates and participating in case conferences as needed (and as outlined in the policy and procedure of the department and lead Health Home providers) to monitor level of care and health status for all assigned members.
• Promptly review and address any crisis situations that arise for any client with supervisory staff, service network and any involved legal entities.
• Provide services to clients as needed to meet Care Plan objectives, including facilitating referrals to medical, behavioral health and social assistance entities; assisting with management of entitlements (Medicaid, SNAP benefits, SSI, etc.); assisting with securing stable housing; and arranging transportation and other services to support wellness and health care compliance.
• Utilize Electronic Health/Medical Record system(s) of assigned Health Home and NADAP database tools to maintain documentation and all relevant treatment records, entering contact notes within the timeframe outlined in the Program Manual guidelines.
• Performs other duties as assigned.

Qualifications:

• Bachelor's Degree in Social Work, Human Services, or related field required
• Degree in social work, public health, or mental health counseling preferred, with two years of experience or a master's degree with one year of experience. Hiring criteria may change depending on the standards of the governing entity of the target population (i.e., DOH, OMH, etc.)
• Requires advanced knowledge of a specialized or technical field or a thorough knowledge of the practices and techniques of a professional field. May require knowledge of policies and procedures, and the ability to determine a course of action based on these guidelines.
• Caseloads may flex based on need and acuity of the targeted population. Flexibility in caseload management required.
• Bilingual Spanish speaker required.

Salary: $60,000/year

Program Overview: Health Homes works in partnership with medical and behavioral health providers to align services that promote access to care and enhanced health outcomes to Medicaid recipients.

NADAP, Inc. is a multiservice non-profit agency dedicated to helping people with medical, behavioral health, and social service needs to become self-sufficient. NADAP programs assist disadvantaged populations in New York City and Nassau County. NADAP's services include health insurance enrollment, assessment, care coordination, case management, professional training, job preparation, and placement services. At NADAP, we believe in creating an environment where every individual is treated with dignity and respect. We are committed to ensuring that all employees and applicants have an equal opportunity to succeed, regardless of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, or any other characteristic protected by law. Visit us at


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