Care Coordinator (Float) - Southern Tier

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The Float Care Coordinator will apply the essential activities of case management which include assessment, planning, coordination, monitoring and evaluation with the core components (Comprehensive Case Management, Care Coordination & Health Promotion, Comprehensive Transitional Care, Patient & Family Support and Referral to Community & Social/Support Services).  The Float Care Coordinator will be responsible for providing Care Coordination services to enrolled clients in times of understaffing. The Float Care Coordinator may also assist the Outreach & Engagement team as needed in times of understaffing, and will maintain a small caseload (up to 12 cases). Essential functions of this role include:

· Completes comprehensive health assessment/reassessment inclusive of medical / behavioral / rehabilitative and long-term care and social service needs

· Completes/revises an individualized patient-centered plan or care with the patient to identify patient’s needs/goals, and include family members and other social supports as appropriate

· Conducts outreach and engagement activities to assess ongoing emerging needs and to promote continuity of care and improved health outcomes

· Prepares client crisis intervention plan

· Consults with primary care physician and/or any specialists involved in the treatment plan, and Coordinates with service providers and health plans as appropriate to secure necessary care, share crisis intervention and emergency information

· Advocate for services and assist with scheduling of needed services

· Links/refers client to needed services to support care plan/treatment goals including medical/behavioral healthcare; patient education, and self-help/recovery, and self-management

· Monitors/supports/accompanies the client to scheduled medical appointment; Follows up with hospitals/ER upon notification of a client’s admission and/or discharge to/from an ER/hospital/residential/rehabilitative setting

Qualified Candidate will have a Bachelor’s degree in health, human or education services and one year of qualifying* experience or Associate’s degree in health, human or education services and two (2) years of qualifying* experience. Qualifying* experience equals professional case management or care coordination experience with the following populations:  persons with a chronic illness, and/or persons with a history of mental illness, homelessness, or chemical dependence. Candidate must be adaptable to change as required due to the fluidity of the Clients served. Candidate must have a valid NYS Driver’s License and an insured, dependable car. Candidate must be able to communicate clearly and professionally in writing and verbally. Candidate must demonstrate ability to navigate computer systems and databases and active listening skills. Candidate must also demonstrate good organizational and time management skills. Sensitivity to HIV/AIDS, addiction and LGBT issues and ability to work effectively with people from diverse cultures and socioeconomic conditions essential.

Job Type: Full-time

Required education: Bachelor’s (plus 1 year experience); Associates (plus 2 years experience)

Required experience: Care Coordination/Case Management; Working with clients experiencing chronic illness, homelessness, mental illness and/or chemical dependence

Additional requirements: Must have dependable, insured vehicle and NYS Driver’s License

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