Adult Care Coordinator (Health Home Plus)

Job Description

Job Description

Summary:

The Adult Care Coordinator (Health Home Plus) conducts and schedules assessments, referrals, advocacy and supports, counseling, education of patients and enrollees and care team members assuring the patient receives quality services to maintain optimum healthcare needs without barriers. The Coordinator adheres to and promotes the philosophy and missions of the company by performing the following duties and responsibilities.

Duties and Responsibilities:

• Responsible for engagement with adults in the care management program.*
• Conducts assessments, evaluates needs, establishes and maintains care plan and maintains referrals for enrollees. Assures supports are in place inclusive of peer and family contacts.*
• Develops Plan of Care based on preliminary clinical information and assigned level that will identify linkages and services immediately required, based on information received from referral sources if applicable.*
• Ensures all initial linkages are established and maintained.
• Collaborates with all services providers and establishes team communication plan.*
• Monitors goals on a continuing basis and that team is communicating.*
• Monitors that care plan is relevant to health home policies and procedures.*
• Consults with family members and social supports to maintain support consistency.*
• Advocates for additional services and linkages as appropriate.*
• Maintains current care management documentation and information regarding care management activities within the required health IT system.*
• Maintain Health Home Plus caseload of 15-20 clients.
• Provide Care Management services to Health Home Plus members with recent homelessness, recent incarceration and/or frequent impatient hospitalizations. 
• Conduct: minimally two face to face client contacts per month with two collateral contacts as well as supporting the client with any referrals for other supported services.
• Participate in all required Health Home Plus trainings and Supervision required for Health Home Plus Care Management. 
• Additional duties may be assigned, on an as needed basis.

Education/Experience

• A Master’s degree in one of the qualifying fields and one-year of experience, OR 

• A Bachelor's degree (B.A.) or higher in any field with three years of experience, or two years of experience as a Health Home Care Manager serving SMI or SED population; OR

• A Credentialed Alcoholism and Substance Abuse Counselor (CASAC) and two years of relevant experience.

• A valid NYS Driver's License is required.
• Cleared with the New York State Central Registry and Department of Health

Qualifying Fields: Degrees featuring a major or concentration in: social work, psychology, nursing, rehabilitation, education, occupational therapy, physical therapy, recreation, recreation therapy, counseling, community mental health, child and family studies, sociology, speech and hearing or other human services.